New contract for general practitioners

Editor- I do not think the doctor and patient relationship will be
compromised to the extent that Shekelle described in the proposed
initiative by the NHS, to improve quality of care by setting performance
targets for general practitioners accompanied by financial incentives.1
I entrust that general practitioners will continue to value their patients
as individuals and not a series of achievable performance targets. Rather,
I think GPs would consider using these targets as tools for aiming to
improve the quality of their service and the efficiency in which it could
be delivered, irrespective of financial rewards. I expect GPs and any
sincere health professional accepting the need for clinical reform, not to
change their behaviour towards patients on the basis of financial gain
alone. This would reflect badly on the profession, the program and the
very reason for its existence.

I do share Shekelle's sentiments about the usefulness of many new
quality indicators in multiple domains of care. This broadens the focus
into other aspects of care, which may have previously been neglected;
however it does not address the problem of care domains that have yet to
be measured.1

The implementation of the proposal may present to be difficult.
However, good clinical governance, a quest for appropriate changes by GPs
and continual input from all those involved should contribute to the
successful implementation of the program, which strives to improve the
quality of primary care in various clinical settings. Although this bold
new proposal presents as a mammoth task, the benefits and ramifications
from its implementation could potentially ensure better outcomes for all
concerned.

1.Shekell, P. New contract for general practitioners: A bold
initiative to improve quality of care, but implementation will be
difficult.
BMJ 2003;326(7387):457-458.[Fulltext]

Competing interests:  
None declared