PRIMARY HEALTH CARE CONFERENCE: The Department of Health's primary care strategy has alienated the medical side of primary care and has not recognised the strengths of general practice, it has been claimed.
Prof Tom O'Dowd, professor of general practice at Trinity College, Dublin, acknowledged that primary care was ultimately "the name of the game" and advised family doctors not to swim against the tide of primary care's relentless progress.
But Prof O'Dowd warned that "primary care needs to value the input of the medical side as it develops". He was giving the annual Dr Donie Burke lecture at the Royal Academy of Medicine in Ireland.
Prof O'Dowd listed the strengths of general practice as having an illness focus and being small-scale and local. It also focused on individuals and families and was regarded as having authority by patients.
Commenting on the weaknesses of the Government's primary care strategy, he said that it was "strong in theory and weak in practice".
"The results will be slow in coming and will be out of synch with the high expectations of healthcare managers", he predicted. While the strategy was correct to target deprived communities, he was concerned that such communities had very few resources to be able to respond.
Because the GP's role would be fragmented, he predicted the end of the old-fashioned family doctor available around the corner. "The reassuring pat on the shoulder will disappear".
Prof O'Dowd acknowledged that teamworking would allow GPs to function at a higher level but said that teamwork was already present in primary care. "Up to two-thirds of patients already get information from general practice from sources other than the general practitioner", he said.
Addressing an audience made up primarily of GPs, he said that primary care would not work without family doctors. "The Department of Health must recognise that GPs are being asked to sarcrifice a lot in return for a new method of working. Doctors in poorer areas will be affected most," he said.
The real issues in primary care and general practice were inequity, accountability and high levels of disease morbidity and mortality. It was more important to address these than to be concerned with the nitty-gritty of the primary care strategy, he concluded.