Medicopolitical Digest

GPs highlight inconsistencies in the white paperConsultants find winter pressures have startedCampbell report should be implementedBMA pushes forward its public health policyMPs are concerned about safety in acute trustsBMA calls for more research into needs of disabled doctors

BMJ 1998; 316 doi: (Published 03 January 1998) Cite this as: BMJ 1998;316:78

GPs highlight inconsistencies in the white paper

GPs have welcomed the emphasis on fairness, equity, and quality in The new NHS, the government's white paper for England published last month (13 December 1997, p 1561). But at its December meeting the General Medical Services Committee highlighted the many inconsistencies, particularly the tension between a needs led primary care service and the lack of extra resources.

There will be a further debate in January, but the committee agreed that it should work with other GP organisations to ensure that GPs remained the safety valve of the NHS and retained the freedom to refer. It was concerned about the proposal for a unified budget and the possibility of cash limiting of general medical services and of prescribing. The negotiators will seek an early meeting with Alan Milburn, the health minister, and call for guarantees that GPs will be allowed to overspend if they need to. Mr Milburn will be invited to a future meeting. The negotiators will consider the advisability of a conference of local medical committee secretaries and whether the chairman should write to all GPs.

Lack of Resources

The concern about the lack of resources ran through the debate. “The white paper is a vote of confidence in general practice,” the chairman, Dr John Chisholm said, “but GPs must not become the fall guys for under-resourcing.” He criticised the assumption that the NHS did not need more money or rationing and that all that was needed was more efficiency. The white paper promises a saving of £1bn in five years, but the committee failed to see how this could be achieved.

Several speakers said that the government must take responsibility for rationing and set out what the NHS could afford.

The future role of local medical committees (LMCs) is uncertain, particularly their relationship with primary care groups and primary …

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