General Practice Manpower and Health Service Reorganization

Abstract

ABSTRACTThe article deals with the geographical imbalance of medical manpower in general practice; it describes corrective policies employed in the NHS, some major administrative problems stemming from those policies, and the prospects under reorganization.First, the problem is seen within the context of inequalities in the distribution of other health and welfare services in the United Kingdom and of medical manpower in other countries. The second section summarizes the three major strategies employed since 1948: the Medical Practices Committee, the Initial Practice Allowances and the Designated Area Allowance. Problems arising from these policies include the fragmentation of responsibility, the lack of agreed objectives and the haphazard nature of the geographical units within which restrictions and incentives operate. The final section deals with the opportunity, presented by the 1973 National Health Service Reorganisation Act, to restructure these unsatisfactory features of the administrative framework. It is feared that the impetus for change is in danger of being lost, and that the establishment of the new health authorities alongside the old, largely unaltered machinery will merely add to the fragmentation of responsibility, thus exacerbating the imbalance of resources.