“The impact of incentives on the behaviour and performance of primary care professionals” is a long and largely tedious report to the DH. http://www.sdo.nihr.ac.uk/files/project/158-final-report.pdf
Among many qualitative quotes is that from GP 208 on page 110 who says:-
“He [Darzi] needs his head kicking in.….He knows jack shit about general practice.”
GP 208 is a perceptive individual.
The Urban Dictionary offers:-
“Jack is the only son of Awe Schitt and O. Schitt. Awe Schitt, the fertilizer magnate, married O. Schitt, the owner of Knee-deep Schitt, Inc. Jack Schitt married Noe Schitt and they had 6 children: Holie Schitt, The twins; Deep Schitt and Dip Schitt, Fulla Schitt, Giva Schitt and Bull Schitt. Jack and Noe divorced. Noe later married Mr. Sherlock and because her kids were living with them, she wanted to keep her previous name. She was known as Noe Schitt-Sherlock. Dip Schitt married Loda Schitt and they had Chicken Schitt. Fulla Schitt and Giva Schitt married the Happens brothers in a dual ceremony. The Schitt-Happens children are Dawg, Byrd and Horse. Bull Schitt left home to tour the world. He recently returned with his new bride, Pisa Schitt.”
Asking a London tertiary surgeon to opine on the organisation of general practice and primary care and then attempting to apply that to the privinces was an approach in which few sensible people I know have found any merit.