In general, universal access to primary care should decrease health inequalities and increase social cohesion, but this would lead to greater health inequalities. For public health centres to be able to scale up into larger practices, they will need the ability to contract private practitioners at higher payment rates and while being allowing doctors to remain independent practitioners. If contract payments are set at a sufficient level, health centres could induce those currently operating their own practice to practice from public health centres by offering the prospect of a stable pipeline of patients (through referrals from screening and other services already delivered at the public health clinic) and sparing sole practitioners from the overhead and administrative costs of maintaining an independent practice.