Improving access to hospital departments may be the better option

In its recently published report a working party of the British Society of Gastroenterology cautiously supported the development of endoscopy in primary care while emphasising that achieving high enough standards of training, equipment, staffing, and skill might be difficult in this setting.1 The report also pointed out that little consideration had been given to local strategic planning of endoscopic services.

Endoscopic examination is important in evaluating and managing upper and lower gastrointestinal problems. Digestive disorders are extremely common in the general population and in general practitioners' surgeries. About 1% of the general population has an endoscopy each year, although this proportion varies widely among health districts and regions.2 3 An endoscopic diagnosis is generally agreed to be required before long term treatment is started, although the introduction of near patient testing for Helicobacter pylori may change practice in relation to duodenal ulcer …