'Corporatisation' threatens UK GPs

US expert warns Darzi centres and decline in partnerships undermining quality.

An international expert on primary care has warned that UK general practice is in danger of following its US counterpart into 'intensive care'.

Professor Gordon Moore, who received the President's International Medal at the RCGP conference in Glasgow this month, said the tradition of general practice here was admirable compared to the 'dreadful state' of US primary care.

But he told the conference that the 'corporatisation' of the UK system, the erosion of continuity of care and loss of established GP skills, were major threats to the future of the profession.

Professor Moore, from the Department of Population Medicine at Harvard Medical School, said: 'The loss of out-of-hours responsibility, the use of nurses and the emergence of Darzi centres, have all reduced the likelihood that a patient will see their own GP.'

He warned that the over-management of referrals by PCTs could de-skill GPs to the point where the NHS could remove the role completely, and said that the increase in salaried GPs could weaken the quality of general practice.

'Corporatisation is coming to a place near you, either through private providers or by principals employing salaried doctors. Salaried GPs without a stake in the practice do not show the same drive to keep that practice at the forefront of excellence.

'The very core of your 60-year story of success could be threatened. The most important things you can do are to remain competitive, alert, and continue to look for the best.

'General practice in America is on life support and we depend very much on you to lead the way.'

Professor Moore said he had been an admirer of the UK system since spending a year studying general practice in 1988. He highlighted its key strengths as the overarching NHS structure, the product offered to patients, the approach to the selection and training of GPs, and the integrated nature of general practice.

For coverage of the RCGP conference visit healthcarerepublic.com/rcgp

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