Health promotion in primary care

BMJ 1996;312:1304 (18 May)

Letters

Health promotion in primary care

Scheme should be comprehensively reviewed

EDITOR,--Stephen Gillam and colleagues are right to questionthe recent modifications to the health promotion package forgeneral practice.¹ I believe, however, that they have failedto identify the changes that could make the scheme worth while.

The package, which was introduced in 1993, was a curious mishmashof data collection, primary prevention, secondary prevention,and management of chronic disease. Some excellent ideas wereconcealed among the mass of requirements, which seemed designedto irritate, depress, and antagonise general practitioners.We know that primary prevention in a one to one consultationis a thankless and largely unsuccessful task and that collectionof data cannot be a serious priority in an overloaded schedule.Management of chronic disease and its corollary, secondary prevention,are, however, the stuff of general practice, requiring a meldof clinical skills, rapport with patients, and family medicine.Unlike primary prevention, secondary prevention . . . [Full text of this article]