Accreditation long overdue
Do GPs with a special interest enhance the profession or undermine it?
This is a question which has split general practice ever since the Government announced it wanted 1,000 'GPSIs' in its 2000 NHS Plan.
A central argument for the anti-GPSI camp has been that there is no foolproof way of telling who is worthy of the name because of the absence of common standards or a national system of accreditation.
Some GPSIs have worked as hospital doctors in their 'interest' for a decade or more before becoming GPs. They have a genuine interest, genuine skills and are genuine GPSIs.
Yet there are others who have gained their status simply by doing a Mickey Mouse training course. They may have a special interest, but they do not have the special skills to match.
Such a gap should never have been allowed to develop.
So while it is to be welcomed that the Department of Health is finally to set up a proper system of accreditation for GPSIs, it should have been done from the start.
It wasn't, of course, because if it had been ministers would have missed their precious target.
Under the proposed three-year accreditation route, GPs will have to make a significant commitment if they are to become GPSIs. Numbers may fall. If that is the case, then so be it. For GPSI services to continue in the era of practice-based commissioning, generalist GPs need to be certain they offer high-quality clinical care as well as value for money.