Even less coherent than before

In his continuing drive to appease disillusioned and overworked general practitioners, Britain's secretary of state for health has made major concessions over the data on health promotion that general practitioners are required to record.1 The more than 120 items of data that were previously required have now been reduced to eight. The move will please those general practitioners who have objected to the “ritualistic collection of risk factors when the public health benefits are marginal,”2 but the reductions seem to have been driven more by the pressure to reduce paperwork than by a desire for effective disease prevention. In the absence of either a strategic or an evidence based approach to health promotion in primary care, many important items have been lost while others have been inappropriately retained.

Under the new scheme, general practitioners are being asked to record the number of patients in …