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It is interesting that the King's Fund report, Improving the Quality
of Care in General Practice, has failed to identify any new measures to
illuminate the slippery issue of quality in primary care, whilst at the
same time suggesting that it will "only arise when GPs and their teams
begin to look beyond the care that takes place within surgery walls" (1).
I would suggest the opposite - that our main problem is that we fail
to care for each other as colleagues and so reside within dysfunctional
and attritional working environments. May I suggest some contributory
1. The imperative that we need to work in larger more "efficient" groups,
is the most alarming. What is the evidence that large groups are more
"efficient" and more humanitarian than small ones?
2. The destabilizing influence of on-the-hoof government dictat and the
role a chaotic Department of Health has played in enforced implementation
in the last decade.
3. The paucity of medical manpower available to deliver quality where
there is increasing medical complexity and very limited time?
(1) The Highs and Lows of Primary Care. BMJ. 342:682-3
GP partner in 5 person practice serving 8000 patients