2 Iceland, too, may be seen as part of this “premier league” of general practice, since all other European countries have less strictly organised health services, with patients often “shopping” between doctors and many specialist health services being in the first line of care.

The last two features are obviously interrelated and make Britain one of three European countries-the Netherlands and Denmark being the others-to practise a personal doctor system at the primary level. Three features have been part of our beliefs about the NHS: a high professional and intellectual standard amidst rather meagre hospital resources, the lasting principle of providing health services “free at the point of use,” 1 and patient registration with general practitioners. The vigour with which the reforms were introduced certainly inspired the Scandinavian countries (although we have heard that there were British doctors escaping to Australia to avoid them). Yet, there has been something special about the NHS, even when seen from abroad.

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