National Health Service (NHS)

Aren't they the same thing (to the extent that LLPs are the "same" as Ltd companies? Surgeries are almost de facto franchises of the NHS, owned and run by various types of organisations, but ultimately wearing the same uniform, locked into purchasing and provisioning agreements and having their wages set by state / trust.

I am no expert on the detail but it was essentially a local GP partnership vs a large international company - any qualified provider or whatever it is being called nowadays. His practice is a partnership so they are essentially self-employed whereas most GPs now are taken on as salaried staff - better pay, less admin and so on. It's a complicated situation but the reality of 'competition' is not.