The assumption that the control of general practice will remain with GPs is
misplaced. There has been a mad rush to get pcgs off the ground on the basis
of a white paper. Individuals are meeting with health authority managers to
cobble up the constitutions of pcgs before any of us has seen the primary, let
alone secondary definitive legislation. The result is going to be cash
starved pcgs required to give precedence to the community rather than the
individual interest, with doctors under threat if they do not stick within
protocols laid down by the National Institute for Clinical Excellence(sic)
which will define cheap rather than good practices. There may also be
sanctions against doctors who do not provide information about their patients
in the community interest. Utilitarianism in medicine is morally and
ethically wrong. (cf International codes of medical ethics] Rationing
decisions are for government, not for doctors.
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