Editorials

Barriers to evidence based policy

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7062.894 (Published 12 October 1996) Cite this as: BMJ 1996;313:894
  1. Dominique Florin, Honorary lecturer in public health medicine
  1. Health Promotion Sciences Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT

    Health promotion in primary care changes again

    This month the policy for health promotion by Britain's general practitioners is changing again, for the third time since 1990. Decisions about health promotion will now be devolved to local general practitioners and health authorities. Effective health promotion depends on a close relation between science and policy. However, these repeated policy changes, tenuously informed as they have been by scientific evidence, illustrate some of the barriers to this relation.1

    In 1990 specified health promotion activities, such as three-yearly health checks and health promotion clinics, became part of the new general practitioner contract. The contract was widely criticised for its lack of scientific basis, and it caused an exponential increase in health promotion payments to general practitioners.2 In 1993 the government abolished health promotion clinics and three yearly checks and replaced them with the health promotion banding system. This was an improvement because it clearly identified health priorities (cardiovascular disease and stroke), but it put the emphasis on paying general practitioners for collecting data rather than for intervening.1 Continued dissatisfaction with the system has led to the latest changes. What does this case history show us about the failure of …

    View Full Text

    Sign in

    Log in through your institution

    Free trial

    Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
    Sign up for a free trial

    Subscribe