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31-10-2010 | Article

Reform concerns

The government may be intent on pushing through its reforms, but there still seems to be some scepticism among the people who are supposed to be at the helm of GP commissioning. That is, the GPs themselves. According to the univadis GP news service (click here), only about a quarter of GPs who participated in a survey think that patient care will improve as a result of the reforms. Not a very impressive figure, although you could argue that GPs may not fully understand the implications and true direction of the reforms. And perhaps that is true to a certain extent - after all, the full details of all the reforms have not yet been made available. Interestingly, in the same survey GPs seemed to think that they do have within their ranks the capacity to lead consortia. That surprised me, because I doubt many GPs have the skills, training and capability to lead consortia. GPs are trained to manage patients and their problems within primary care, not lead big businesses within the constraints of the politicised arena of the public sector.

Another aspect of this survey run by the King's Fund was that many doctors thought that the reforms would improve working relationships between doctors in primary and secondary care. Again I have my doubts about this, and only time will tell. I think we are all in unchartered waters and I hope that many of these reforms will be trialled first and evaluated rather than introduced rapidly. I somehow fear the latter is more likely.

Talking of the new reforms, the Royal College of General Practitioners (RCGP) is still suggesting that GP practices should form federations. However, I am not to clear where that sits with the government's plans. According to the univadis GP News service (click here), the RCGP's Chairman thinks that GP federations can work with consortia. This just confuses the issue for me!

Elsewhere, National Institute for Health and Clinical Evidence (NICE) guidance on treatment for bedwetting for children under age seven has been announced (click here). There is no minimum age for treatment, which is helpful, and the guidance shines a light on a relatively common, but I suspect, sometimes overlooked problem.

Best wishes,


Dr Harry Brown, editor-in-chief

By Dr Harry Brown