Is bigger better for primary care groups and trusts?

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7303.49 (Published 07 July 2001) Cite this as: BMJ 2001;323:49

Small can be beautiful and effective

  1. Jon Levick (Jon@vindomora.demon.co.uk), chairman
  1. Derwentside Primary Care Group, Shotley Bridge Hospital, Consett, County Durham DH8 0PW
  2. Huddersfield HD3 3SH
  3. Meanwood Group Practice, Leeds LS6 4JN

    EDITOR—Bojke et al highlight the importance of deciding the optimal size of primary care organisations.1 Their article reinforces my view that if these organisations are to fulfil their potential then false economies of scale must not be the main driving factor, as they have been with so many NHS reorganisations in the past.

    For once the development of an NHS organisation should be based on its key roles and the environment in which it works to enable it to be as responsive as possible. This is especially the case for primary care organisations. It would be a disaster for primary care and local services if these organisations became reincarnations of health authorities or developed into the inflexible hierarchical institutions that are hospital trusts.

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