"Super surgeries" threaten general practice
http://www.100md.com
《英国医生杂志》
Super sized surgeries and a confusingly large number of ways of accessing NHS care are threats that could "shake general practice to its core," GPs heard last week at an annual conference.
Doctors at the BMA's local medical committees conference in London voted overwhelmingly for a motion saying the government was misguided over the value it gave to the "super surgeries," which would bring several services such as dentistry, health visitors, and a pharmacy as well as general practice under one roof, and that they would not improve quality of care.
Dr John Dracass of the West Hampshire local medical committee proposed the motion and attacked plans by the Modernisation Agency, describing them as a "change in the provision of primary care that will shake general practice to its core and go a long way to destroy it."
"The proposal... is to crush singlehanded and small practices in favour of giant super surgeries of 10 or more doctors. The current 10 000 British practices would shrink to a miserable 1800."
The idea to restructure primary care into three tiers—walk-in centres, networks of larger practices, and single specialist units—was also rejected in the motion.
In a separate debate a guest speaker, Professor Chris Ham, health policy analyst at the University of Birmingham, warned the audience of 600 GPs that they had to get involved in changes to the NHS before the expected white paper on primary care, which is due in the autumn.
Professor Chris Ham says GPs need to move towards services that are more integrated
Credit: JASON ALDEN/NEWSCAST
"Super surgeries are short hand for much more integrated services," he said. "We need to walk towards that. Either we do it ourselves or other people come in and do it for us."
Standards of out of hours care were also criticised. Doctors voted overwhelmingly for a motion saying that patients' lives were being put at risk because of the government's failure to fund out of hours care properly and because many doctors last year chose to opt out of providing the service.
Dr Andrew Green, from the East Yorkshire local medical committee, said: "Rather than having proper local provision, we had a doctor arriving at 8 pm for an overnight shift, having travelled 12 hours from Budapest carrying a clinical bag and a packet of sandwiches. Safe out of hours is worth paying for."
GPs also voted overwhelmingly for another motion calling on the BMA's General Practitioners Committee to investigate the extent of the threat posed to primary care by the private sector.
In his address to the conference the committee's chairman, Dr Hamish Meldrum, spoke of the government's "headlong rush to create more private sector provision of NHS care." He said, "Where is the evidence that it will improve rather than destabilise our present system of general practice?" (See editorial p1460)(Adrian O'Dowd)
Doctors at the BMA's local medical committees conference in London voted overwhelmingly for a motion saying the government was misguided over the value it gave to the "super surgeries," which would bring several services such as dentistry, health visitors, and a pharmacy as well as general practice under one roof, and that they would not improve quality of care.
Dr John Dracass of the West Hampshire local medical committee proposed the motion and attacked plans by the Modernisation Agency, describing them as a "change in the provision of primary care that will shake general practice to its core and go a long way to destroy it."
"The proposal... is to crush singlehanded and small practices in favour of giant super surgeries of 10 or more doctors. The current 10 000 British practices would shrink to a miserable 1800."
The idea to restructure primary care into three tiers—walk-in centres, networks of larger practices, and single specialist units—was also rejected in the motion.
In a separate debate a guest speaker, Professor Chris Ham, health policy analyst at the University of Birmingham, warned the audience of 600 GPs that they had to get involved in changes to the NHS before the expected white paper on primary care, which is due in the autumn.
Professor Chris Ham says GPs need to move towards services that are more integrated
Credit: JASON ALDEN/NEWSCAST
"Super surgeries are short hand for much more integrated services," he said. "We need to walk towards that. Either we do it ourselves or other people come in and do it for us."
Standards of out of hours care were also criticised. Doctors voted overwhelmingly for a motion saying that patients' lives were being put at risk because of the government's failure to fund out of hours care properly and because many doctors last year chose to opt out of providing the service.
Dr Andrew Green, from the East Yorkshire local medical committee, said: "Rather than having proper local provision, we had a doctor arriving at 8 pm for an overnight shift, having travelled 12 hours from Budapest carrying a clinical bag and a packet of sandwiches. Safe out of hours is worth paying for."
GPs also voted overwhelmingly for another motion calling on the BMA's General Practitioners Committee to investigate the extent of the threat posed to primary care by the private sector.
In his address to the conference the committee's chairman, Dr Hamish Meldrum, spoke of the government's "headlong rush to create more private sector provision of NHS care." He said, "Where is the evidence that it will improve rather than destabilise our present system of general practice?" (See editorial p1460)(Adrian O'Dowd)