Dr. Ray Walley:

The Dutch spent 30 years developing community care and general practice. The problem with primary care is that a lot of people do not know what it is. Professor Barbara Starfield wrote about primary care physicians, which are an American phenomenon, but we are GPs and the equivalent in the Netherlands and the UK are also GPs. It is important not to use opaque terminology.

The key thing is that if there are enough GPs, morbidity and mortality rates go down. Clinicians are decision-makers on the basis of evidence-based medicine, their training and a continuous review of the literature. If the system is not led by clinicians, there will be more medication use.

The majority of those who come to me with a cough have a viral illness and do not need an antibiotic. I have the training and experience to be able to say this and they understand and accept it. When a person has been a patient of a particular doctor for five years, he or she builds a relationship such that he or she believes what the doctor has to say.