• general practice
• healthcare

In common with other healthcare services in the United Kingdom, general practice (GP) is faced with an ever increasing pace of change which is best highlighted by the implementation and implications of the new GP (General Medical Services, GMS) contract.

In the light of these changes, the increasing expectations of parents, the escalating presentation of disease, ill health, and mental health issues amongst children, it seems reasonable to ponder the future for child health care provision within GP.

It seems reasonable to expect there to be a comprehensive child health service in GP because the frequency of presentation of acute illness and the ongoing management of certain key chronic diseases are likely to be beyond the capacity of any rational existing and future secondary care/mental health and community paediatric service plan. The Wanless report¹ highlights the inadequacy of the doctor population in the United Kingdom for the foreseeable future. It is therefore remarkably unlikely, even with the Children’s National Service Framework (NSF), that the number of paediatricians will expand to any significant extent at the expense of other medical or surgical disciplines where performance targets remain.

The implementation of the European …