Abstract
This will be a challenging year for primary care. Public dissatisfaction with the health service as a whole has not abated over the Christmas break, and the release of figures illustrating the wide variations in health spending between different areas of England has been a seasonal gift to critics of the Government’s plans. Scotland, Wales and Northern Ireland too show wide regional disparities in health spending, although costs arising from geographical isolation account for some of the variation. The challenge for the government in Westminster and the devolved assemblies will be to fulfil promises of higher spending while addressing the need for real reform to deliver local independence and flexibility.
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