Public health doctors and general practitioners: Poles apart?

Abstract

On 1 April 1996, the new health authorities will be created. This organisational change will be accompanied by a wider remit for public health doctors than the traditional definition of public health. The future public health roles and responsibilities will include ensuring that public health considerations drive the authority's purchasing and commissioning activities, the monitoring of health outcomes of interventions, and improving the effectiveness and value for money of clinical and non-clinical interventions. Public health doctors, in particular Directors of Public Health, will have a strong influential role in the corporate management team. As a result there is a possibility that general practitioners may feel threatened by what they see as a “top down” approach to the provision of health care, erosion of their clinical freedom and the doctor-patient relationship. Although their perspectives may differ, there is considerable common gorund between public health doctors and general practitioners. Collaboration in the undergraduate curriculum and representation in the annual public health reports are just two ways in which liaison may be encouraged. Developing and sustaining an effective relationship will depend on both parties. General practitioners need to overcome their mistrust of the corporate role of public health doctors, while the latter could meet this criticism by showing an independent spirit through their annual reports and support for equity.