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Rheumatology 1999; 38: 1174-1176
© 1999 British Society for Rheumatology

Editorials

Primary care rheumatology—leading the way?

P. S. Helliwell and J. Hetthen1

University of Leeds and St Lukes Hospital, Bradford and
1 St Lukes Hospital, Bradford, UK

Correspondence to: P. S. Helliwell, Rheumatology and Rehabilitation Research Unit, 36 Clarendon Road, Leeds LS2 9NZ, UK.

Yet another National Health Service (NHS) reorganization is upon us. This `restructuring' (more a change of emphasis) has the potential to cause major changes in the way health care is delivered. The government, encouraged by the success of pilot total purchasing schemes, wishes the NHS to be driven by primary care. Since 1 April general practices have been organized into primary care groups (PCGs) of about 100000 patients and each PCG has a management structure of a chief executive, chairman and board which includes lay and non-medical professionals. Each PCG will provide and commission services according to local need. PCGs will be `feeling their way' initially, but those who develop innovative structures will be given appropriate accolade. Cost savings will be carried over. There is a possibility that some PCGs will eventually become trusts and thus function effectively as `health maintenance organizations'.

Prior to the current reorganization, new Health Service . . . [Full Text of this Article]

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