Headlines: November 25th, 2005

There is a new call today for the special relationship between patients and family doctors to be preserved in any developments in primary care. In an editorial published today in the “British Journal of General Practice” Dr Mayur Lakhani, Chairman of the Royal College of GPs, says new policies should build on the strengths and values of general practice.Dr Lakhani writes about the Department of Health’s White Paper on care outside hospitals, which is expected to be produced later this year or early in 2006, and outlines the issues the Royal College will bring to the attention of the Secretary of State for Health to try to influence and shape the White Paper.

His editorial refers to the views of patients who attended a consultation event organised by the RCGP and where they stated that the special relationship between a patient and a GP had to be retained in any future developments. That view, he says, is echoed by Royal College members who have called for practice-based registration to be preserved. Dr Lakhani’s editorial emphasises the way in which practice-based registration has enabled personal and organisational continuity and co-ordination of care. “There is a substantial research base to support the preservation of primary care based on registration with GP practices,” he writes.

Patients at the RCGP event said specifically that they did not want to see service fragmentation and the Royal College itself believes policies that break up services into ‘disease categories’, which different providers can compete for, should be avoided. “The College will urge the Department of Health to tackle fragmentation of care by better coordination and integration of care across the interfaces,” Dr. Lakhani writes. He says, too, that current Department of Health policies on contestability and diversity of provision are of concern to many GPs and could “lead to a declining GP profession.

Dr Lakhani wants GPs to rise to the challenge and he is calling for them to present their own ideas for improving primary care to ensure unity and collaboration between practices to maximise opportunities in any new arrangements. Dr. Lakhani says patients, doctors and policy makers all want improvements in access, standards and services but the key question is how this can be achieved. The College, he says, will urge the Secretary of State to promote policies that build on the strengths and values of General Practice.

“Good GPs will continue to be essential in any future configuration of primary care with the optimal role of the GP being that of the advanced medical generalist dealing with diagnosis and coordination of care,” he says.