What’s happening in general practice: capitalist monopolisation and state administrative control: a profession bailing out?

Abstract

The argument of this paper is that the processes of corporatisation - the purchase of general practices by investment corporations - in combination with state surveillance initiatives are fundamentally restructuring general practice in Australia. There are three components to this argument, operating at the sociological, the political-economic, and policy levels. First, within sociology, any recourse to the theoretical model of ‘medical dominance’ no longer holds the explanatory power it once did to explain the position of the medical profession. Secondly, at the level of political economy, it is argued that the development of corporate investment will significantly transform general practice, away from non-profitable interventions, the servicing of at risk groups, or those in the non-urban areas, to population groups and interventions that are profitable. Thirdly, at the policy level, it is suggested that these developments raise important questions about the continued funding of a universal health care system, where public moneys are being accessed for private corporate investors, backed by speculators on the share market. The importance of this issue cannot be overstated in the context of vertical integration - the ownership of general practices, radiology, and pathology services, under the one corporate umbrella - where these companies anticipate that this integration will be a way of producing referrals from the GP through the system, with the goal of increasing profitability.

Keywords:

• corporatisation
• medicare
• professions
• state