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Welfare Reform on the Web (June 2002): National Health Service - Primary and Community Care

AUTONOMY AND BUREAUCRATIC ACCOUNTABILITY IN PRIMARY CARE: WHAT ENGLISH GENERAL PRATITIONERS SAY

S. Harrison and G. Dowswell

Sociology of Health and Illness, vol. 24, 2002, p. 208-226

Paper uses interview data from 49 GPs to explore their perceptions of how National Service Frameworks, guidelines, membership of Primary Care Groups and clinical governance have impacted on professional autonomy. Found clear evidence of acceptance by GPs, under pressure from Primary Care Groups, of the need to maintain records of their clinical decisions. This opens up the possibility of external surveillance of medical work and implies a reduction in clinical autonomy. GPs may regret this situation but are offering little resistance to it.

BENEFIT OR BURDEN? THE RISE OF GPS WITH SPECIAL INTERESTS

C. Richardson

Primary Care Report, vol.4, no. 5, Mar. 20th 2002, p. 38-39

Opinion is divided about how useful GPs with a special interest will be to primary care. Benefits include:

  • reduced waiting times; cost effectiveness;
  • GP career development;
  • increased communication between sectors.

Concerns are:

  • lack of standardised training;
  • removal of GPs from core primary care;
  • the threat to generalism.

CUTTING MANAGEMENT COSTS MAY STIFLE PCTS

S. Brown

Primary Care Report, vol.4, no. 5, Mar. 20t 2002, p. 14-16

The Labour government is committed to driving down management costs in the NHS. It has therefore required fledgling Primary Care Trusts to work within a strict limit on management costs. This has stifled development in many areas and is getting in the way of achieving NHS plan targets.

"DRUG COSTS BLOW APART OUR BUDGET"

 

G. Young

Guardian, Apr. 3rd 2002, p. 21

A GP gives his views on the Labour government's NHS reforms from a primary care perspective. Comments on primary care funding, the development of specialist GP services, and NHS structural reforms.

KEEP TAKING THE TABLETS

A. McGauran

Health Service Journal, vol. 112, Apr. 11th 2002, p. 18-19

The pharmaceutical industry is concerned that the newly launched primary care trusts may lack expertise and organisational infrastructure to cope with their commissioning role.

NURSE DIRECTORS SHOULD PLAY A KEY ROLE IN MODERNISATION

Y. Sawbridge

Primary Care Report, vol.4, no. 5, Mar. 20th 2002, p. 46-47

Argues that Primary Care Trusts should appoint nurse directors to their executive boards.

ONE STEP AT A TIME

A. Moore

Health Service Journal, vol.112, Apr. 18th 2002, p.16-17

Reports on the role of public health directors in the new primary care trusts.

PCTS NEED TO BE PREPARED FOR THE LONG HAUL

P. Anderson

Primary Care Report, vol.4, no.5, Mar. 20th 2002, p.4-6

Points out that it could take up to two years for the latest NHS restructuring involving the abolition of health authorities and the transfer of commissioning functions to primary care trusts to be completed.

PMS MOOD SWINGS

A. Moore

Health Service Journal, vol.112, Apr. 4th 2002, p. 12-13

Presents a range of comment on the progress of the personal medical services pilots. The scheme aimed to employ salaried GPs to improve services in deprived areas where traditional primary care under the general medical services contract was underperforming.

PRIMARY CARE PHYSICIANS' ATTITUDES TO HEALTH CARE REFORM IN ENGLAND

D. K. Whynes and D. L. Baines

Health Policy, vol.60, 2002, p. 111-132

Paper reports the results of two surveys of GPs' opinions on the English health care reforms of the early 1990s, including fundholding. Results show that, first, those who voted to become fundholders were more supportive of the scheme than those who did not, and that this support continued after the scheme had been abolished. Secondly, professional attitudes in respect of other terms of service in primary care remained homogenous to a considerable degree over time. Finally, physicians in favour of user charging tended to be those with responsibility for more patients, suggesting a perceived need to manage user demand.

SECOND COMING

J. Shamash

Health Service Journal, vol. 112, Apr. 4th 2002, p. 12-13

Medicentre clinics offer a private GP service from a handful of sites in London. New owners plan to turn this into a nation-wide chain within two years.

SHIFTING THE BALANCE OF POWER: PRIMARY CARE TRUSTS: GOVERNANCE ARRANGEMENTS, REMUNERATION AND ALLOWANCES

Department of Health

[London]: 2002

Administrative letter details changes to the governance arrangements for primary care trusts to maximise local flexibility.

STARTERS ORDERS

C. Gallagher

Health Service Journal, vol. 112, Apr. 11th 2002, p. 14-15

Reports on how the newly launched North East Leeds Primary Care Trust is responding to the challenges it faces.

UNKNOWN QUANTITIES

A. Moore

Health Service Journal, vol. 112, Apr. 4th 2002, p. 11-12

On April 1st 2002 primary care trusts assumed responsibility for commissioning, public health and primary care from now defunct health authorities. Article discusses the challenges they face, including financial constraints, lack of management expertise, and staff shortages.

UP AND OVER

P. Smith

Health Service Journal, vol. 112, Apr. 11th 2002, p. 12-13

Reports that senior managers from local authority social services departments are taking up positions in primary care trusts. This should help to break down the old divisions between health and social care.

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