ABSTRACT
On 1 April 1990, the third Thatcher administration imposed a new contract upon British general practitioners (GPs). As part of its plans to remake both the National Health Service (NHS) and UK public health, the Conservative Government made available to GPs for the first time specific remuneration for undertaking special health promotion clinics – a service which covered a range of chronic conditions and their risk factors. 1 By 1993, subsequent Conservative governments had introduced distinct incentives for ‘chronic disease management’ clinics, issued protocol to outline process measures required for chronic disease payments, and incorporated a number of chronic diseases in new target-based public health programmes. 2
