Views And Reviews

Local medical committee conference

BMJ 1994; 309 doi: (Published 02 July 1994) Cite this as: BMJ 1994;309:60
  1. L Beecham

    “The traditional professionalism of general practitioners is being undermined and we are being turned into a demoralised and demotivated workforce, many of whom are counting the time to retirement.”

    The chairman of the General Medical Services Committee, Dr Ian Bogle, had no doubt where the blame lay for his constituents' loss of morale when he addressed the local medical committee conference last week. Ministers often failed to encourage general practitioners in their public pronouncements. Departmental officials undermined the pride that general practitioners had in their work. The introduction of greater management control and accountability into the service in 1990 had led to many confrontations between family health services authorities (FHSAs) and doctors. Some FHSA managers not only undervalued the work done in general practice but seemed unaware of how their actions undermined a practice's stability.

    Workload had increased relentlessly — this was the dominant theme during the two day meeting. Many doctors, Dr Bogle said, considered that much of the new work engendered by the 1990 contract was clinically inappropriate and had been accompanied by an expansion in bureaucracy and paperwork. Patients' expectations of what primary care could deliver were unrealistic when measured against current workload and limited resources. There was an inappropriate and irresponsible use of out of hours services.

    Dr Bogle said that he believed that the minister for health now appreciated that there were genuine areas of concern. He hoped that this was a real change of attitude by the government. If the commitment was followed by action the profession should respond positively.

    Health promotion bands should be abandoned

    The health promotion scheme, which was introduced a year ago and provides for payments under three bands (pounds sterling 420, pounds sterling1135, and pounds sterling 2015), is very unpopular. The conference showed how unpopular by instructing the GMSC to get rid of it and …

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