Last minute advice on the start up of 481 primary care groups in England on 1 April came last week from the Commons health committee. After hearing evidence from a health minister and the BMA (BMJ 1998;317:1459), the committee found that the timetable was “extremely tight.”
It recommended that more guidance should be issued as quickly as possible to ensure that the project runs smoothly. As a result of the BMA estimate that 155 extra GPs will be needed nationally to provide cover for doctors serving on primary care group boards, the committee has asked the Department of Health to review the cover arrangements to establish the extent of any problems.
Warning of a potential conflict of interest between the responsibility of primary care groups for clinical governance and GPs' independent contractor status, the committee advised that GPs should be given reassurance that their clinical freedom would not being curtailed.
Similar problems are foreseen over unified, cash limited budgets. It is not clear how problems of overspending on prescribing will be resolved.