The British National Health Service was formed 50 years ago by the post war Labour Government linking together various hospitals and reimbursing General Practitioners (GP's) as stand- alone independent practioners. After efforts by the last Conservative Government to strengthen GP's preferably organised in group practices, as surrogates purchasers of health care for their patients, thereby introducing an internal market, the new government has succeeded in bringing GP's together in primary care groups of 100,000 population. These may then opt to become Trusts, managing their health care budget, and controlling resources at present organised (formerly "purchased") by the Health Authorities. It is thought the government will not want Primary Care Trusts to be larger than 200,000 population.
An interesting pointer at the end of this extract from a statement by British health minister John Denham, last week, is damning the independent practitioner status of GP's with faint praise - an indication that the government intends to open the door more widely to the possibility of GP's becoming salaried professional employees of the National Health Service, an important step in the socialisation of the system.
I hope this piece may give some comparisons particularly for subsribers in the USA with the concept of HMO's
Chris Burford
London
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"By creating Primary Care Groups - and in the near future, Primary Care Trusts - we're building with GPs and other health professionals, the powerful structures that can bring about the changes we want to see.
"Primary Care Groups and Trusts at the heart of their communities. Developing each practice, in its own right and as part of a strategy developed and shared with others to improve primary care across the whole community".
Mr Denham told the conference he expected health authorities to play a full role in developing Primary Care Groups and Trusts. He said he would be making it clear to health authorities that they must put in place the support and assistance that would enable every Primary Care Group that wishes to take on extra responsibility to do so.
Mr Denham reassured general practitioners that they are central to the Government's vision of the way primary care should be developed. The new NHS will thrive with GPs operating, as they have successfully for the last 50 years, as independent contractors where they choose to do so.