CURRENT ISSUES

Tune for a new role for GPs? While primary care is the subject of much

philosophical debate and declaration, this medical discipline has 'lost its way, descending into a pit of management jargon and embarking on defensive fence building', says Lancet editor Mr Richard Horton.

Primary-care medicine has traditionally provided first contact with the patient, as well as continuity, comprehensiveness and coordination of care. However, these unique features may need to be re-evaluated, with the possible result being a 'narrower but more effective role' for the general practitioner (GP), suggests Mr Horton. The integration into general practice of allied healthcare professionals, such as nurses, is essential if continuity and comprehensiveness are to remain defining features of primary care.

Tackling health inequalities? Mr Horton suggests that, if GPs were to evolve

a new role for themselves, one possible goal could be to tackle inequities of healthcare access. Such a role will become increasingly important as urban centres lose their primary-care services and rural services are threatened by centralisation of care into larger hospitals.

'General practice is probably the best instrument we have for tackling health inequalities', says Mr Horton. 'A common cause forged between primary care and social medicine would secure a new and strong place for general practice in national healthcare . , servzces . Horton R. Evidence and primary care. Lancet 353: 609, 20 Feb !999

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PharmacoEconomics & Outcomes News 27 Feb 1999 No. 201