Medical Practices Committee Research Articles

Contribution of general practice to NHS patients

I commend the article by Wilson et al. (January 2006 JRSM1). Regarding the equity of general practitioner provision, the authors correctly point out the under provision in some working class areas. Government policy is to introduce non-NHS providers, including multinational private health corporations. No mention is made of the former Medical Practices Committee, which stopped GPs practising in over-doctored areas, like Kensington, and gave financial incentives to doctors setting up in under-doctored areas.

Trends in geographical inequalities in provision of general practitioners in England and Wales

The figure plots the trend in the inequality index based on both actual and need-adjusted populations. There was a decline in inequality from 1974 to mid 1980s but inequality then stopped falling and may even have increased. In 1995, 2·9% of GPs would have had to move to achieve an equal provision per head of population. Equal provision per head of need-adjusted population would have required the movement of 5·2%. This would have implied substantial changes in GP/need-adjusted population ratios for some areas: the maximum increase required was 36·7% and the maximum decrease was 26·8%. The finding that there is still substantial inequity is supported by other studies. The distribution of GPs is regulated by the Medical Practices Committee (MPC) which defines two types of under-doctored areas: designated (less than 4 GPs per 10 000 population) or open (between 4 and 4·8 GPs per 10 000). The numbers living in open or designated areas fell from 30·4 million in 1974 to 3·4 million in 1994. The MPC argues that it has been successful in reducing inequality. The MPC uses an absolute inequality concept: provision is compared to some absolute standard. The Robin Hood index reflects relative inequality: provision is compared between areas. A 10% increase in the number of GPs in all areas would reduce absolute inequality but would have no effect on the Robin Hood index. Our finding that there has been no recent reduction in relative inequality suggests that new methods for influencing the location of GPs should be considered.

Medical Practices Committee's surveys of vacancies in general practice look at all vacancies

EDITOR,—In their study of factors influencing the response to advertisements for vacancies in general practice Robin Carlisle and Sue Johnstone used a questionnaire based on that used by the Medical Practices Committee in its study of 1994.1 Their references also include one to the committee's recruitment survey report of 1995.2 The committee's aim is to ensure that, when account is taken of the …

Why the government will not abolish the Medical Practices Committee

Why the government will not abolish the Medical Practices Committee

From the LMC conference: Medical Practices Committee

From the LMC conference: Medical Practices Committee

NHS a campaign issue for June election

Doctors who would dearly like to see politics thrown out of medicine are in for an uncomfortable time as politicians reso? lutely drag the National Health Service on to the political hustings. Even the Acheson report, now ripening into maturity in the Department of Health and Social Security, seems destined to be caught up in the rising election fever at West? minster, fever that will spread nationwide now that the election date of 9 June has been announced. The encouragement of inner city group practices rather than giving elderly general practitioners cash incentives to retire once and for all, thus making way for younger men, looks like being the government's way of resolving the dilemma presented by Professor E D Acheson's report. The money has been available for months, and Mr Kenneth Clarke, the health minister, has denied that there was any Treasury opposition to the DHSS getting the ?3m to spend in the next financial year on imple? menting Acheson's recommendations. He did not, however, deny the suggestion that the Treasury was unhappy about giving elderly general practitioners such payments because of the implications for other professions in which people work beyond normal retiring age. The DHSS, however, does not stand up the tale, but it could still be true. The suggestion was that elderly general practitioners in inner cities would have been offered something between ?10 000 and ?\2 000 as final settlement? give up and go gift. It now looks as if Mr Clarke, who insisted in the Commons committee considering the Health and Social Services Bill that the subject of Acheson was a maze and minefield, has decided to offer the money to doctors planning to set up group practices instead. That would not exclude elderly doctors who want to carry on working but would mean them doing so in the company of younger men. Just when this will be done is still anybody's guess. The minister said, however, that the govern? ment intended to announce the details as soon as possible. He also said that the Medical Practices Committee had made clear that it regarded new vocationally trained doctors of maturity and ability as suitable contenders for singlehanded inner city practices. The committee had also said that inexperience would not in future be bar to consideration. He had, he told MPs, taken the problem up with the Medical Practices Committee because at present young, inexperienced applicants could not get its approval to set up practice in London. The committee had announced as result that matters would not follow that pattern in future. The minister has not yet reached the stage at which he is able to make an announcement. Acheson, he told the committee, made no fewer than 115 recommendations and those addressed to the government were of complex and difficult nature. Now the June general election will overtake him, but package for the inner cities would be popular election offer. Certainly the future of the NHS is going to be campaign issue, and such package would be one means of countering Labour's remark? ably successful attack on the way the Conservatives have dealt with the NHS.

Correction: Medical Practices Committee

Correction: Medical Practices Committee

Medical Practices Committee.

Though it affects all general practitioners, the Medical Practices Committee and its workings are little understood. It was set up to implement the principle of the National Health Service that there should be adequate numbers of family doctors throughout the country, and the way it classifies an area may affect con? siderably the general practitioners practising there. In areas considered to be overdoctored, for example, it may prevent doctors taking a partner or setting up in practice, while doctors in severely underdoctored areas may be entitled to substantial financial allowances. The MPC's principal function is to control the distribution of GPs in England and Wales (there is a separate MPC for Scotland, and Northern Ireland has different arrangements). It does this by considering all applications for inclusion on the medical lists kept by family practitioner committees and by reviewing the need to fill practice vacancies. Its actual controls are negative ones: the MPC cannot tell doctors where to go, but it can tell them where they may not practise. The MPC also acts as an appeal body on decisions by FPCs to refuse the employment of assistants or allow the use of surgeries that have been used by another GP. Doctors may also apply to the MPC for a certificate to show that partnership arrangements do not include the sale of goodwill (which is forbidden in the NHS).

General Practice Manpower and Health Service Reorganization

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.

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee

Medical Practices Committee