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Increasingly the future organisation of paediatrics at secondary level, the place of first referral, depends greatly on the organisation and quality of care at primary level. The ability of paediatricians to influence primary child health care is limited at present to advocacy and training, but recently some have been expressing the view that we in the UK should follow US and European practice in developing the concept of primary care paediatricians. Whilst the Court Report in 1976 (“Fit for the Future”) introduced the concept of the GP paediatrician, this was intended to be a GP with additional training rather than a trained paediatrician, as we know it today.
Clearly there are many potential benefits of paediatricians working in primary care to provide specialist care and manage chronic conditions. Some also argue the case for management of acute illness at this level. However there may be potential pitfalls; not least whether these concepts fit with current ideas of service planning by general practitioners and health service managers.
Hence we have asked a range of experts with specific expertise to describe their perspective on the future of paediatric primary care and the interface with secondary care, as well as seeking the perspective of the RCPCH. These issues are for debate and we encourage readers to contribute their views through a rapid response.