UK GPs will produce blueprint for the future

BMJ 1999; 319 doi: (Published 03 July 1999) Cite this as: BMJ 1999;319:12
  1. Linda Beecham
  1. BMJ

    General practitioners in the United Kingdom, other healthcare workers, patients, policymakers, and politicians will be asked to contribute ideas over the next few months to a consultation document on the strengths of general practice, the threats, and the solutions for the next decade.

    Announcing this at the conference of local medical committees last week, John Chisholm, chairman of the General Practitioners Committee, said that it was time for GPs to define their own agenda for the future: “We need to take stock of what being a GP should mean in the next millennium, what we need from government, and what we expect of ourselves.”

    The document will be sent to all GPs early in 2000 and as part of the process there will be a national General Practitioners Committee conference in March. The feedback will lead to the profession's white paper, which will also go to all GPs. The decisions that will form the future negotiating agenda will be taken at the local medical committees conference in 2000 to be held in Manchester. These decisions, Dr Chisholm said, would need to protect the fundamental characteristics of general practice and its pivotal role, and “ensure a service of which we and our patients can be proud.”

    The frustration of GPs was highlighted in many of the debates. The conference deplored the haste with which recent reforms, such as primary care groups and trusts, have been implemented without adequate information, proper piloting, or provision for ongoing evaluation.

    “It is time the government recognised that there has been underresourcing at every stage—too little money for preparation, too little for continuing costs, too little money for organisational development, and too little for investment in the information systems that are essential for strategic planning and clinical governance,” Dr Chisholm told the meeting.

    GPs want the government to clarify what importance it places on their future role, as many believe the introduction of NHS Direct and walk in centres threaten their gatekeeper role and will divert scarce resources “from the urgent and serious to the relatively trivial.”

    There was strong support from a motion that called for the concept of the family doctor to be fiercely defended. Peter Skolar, who practises in north London, said, “I face becoming a primary care consultant working out of a Russian-style polyclinic where I have no registered patients and where there will be no continuity of care.”

    GPs are worried about the dilution of professional influence when primary care groups in England and local health groups in Wales become primary care trusts.

    The conference voted overwhelmingly for a secret ballot of GPs in the area before the primary care trust was agreed. The proposal must come from the relevant primary care group or local health group and there must be consultation with the local medical committee. (See p 61).

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