Intended for healthcare professionals


Does the new NHS need personal medical services pilots?

BMJ 1999; 318 doi: (Published 15 May 1999) Cite this as: BMJ 1999;318:1302

They offer a testbed for primary care trusts

  1. Stephen Gillam, Director.
  1. Primary Care Programme, Kings's Fund, London W1M 0AN

At the time of its publication in late 1996 the Choice and Opportunity white paper was seen as heralding revolutionary changes in British general practice.1 The “listening exercise” by the then health minister, Stephen Dorrell, had identified once more the inflexibility of existing contractual arrangements as a major barrier to remedying poor quality primary care, particularly in inner cities. The Primary Care Act, squeezed through in the final weeks of the last government, allowed health authorities scope for the first time to commission primary care from any local provider within the NHS family, better tailored to meet local needs. Proposals were invited to pilot these new arrangements, though the possibility of experimenting with unified budgets for general medical services and hospital and community services was suspended. Altogether 567 bids of various shapes and sizes were received initially. After a protracted selection process 94 quietly went live in April last year. More white papers and much else have happened since the launch of this policy initiative. So do the personal medical services pilots …

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