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BMA sets out White Paper demands

By Daile Pepper

GPs are vowing to refuse to take responsibility for a new breed of medical care practitioner because of concerns over patient safety.

They accused the Government of attempting to replace doctors with a cheaper option and causing confusion among patients about the relative skills of 'general' and 'medical care' practitioners.

Under Department of Health plans announced this month, hundreds of medical care practitioners will eventually be employed in the NHS.

They will go through two years' training in general medicine to attain a masters level degree and will then work with the supervision of a doctor.

But they will have the power to diagnose, treat and refer patients with a wide range of conditions and to prescribe.

GPs will retain legal responsibility for any medical care practitioner under their charge.

Dr Terry John, a GP in north London and chair of the GPC educational subcommittee, said he would not take responsibility for practitioners' work if he thought they were working above their skill level.

'If it is going to draw people into the NHS then I think it is worth looking at,' Dr John said of the scheme.

But he added: 'It's not really clear what it is these people will be able to do. They are not replacement doctors.'

Dr Nigel Watson, Wessex LMCs chief executive, said it was impractical for GPs to be responsible for decisions the practitioners made: 'How can you be responsible for somebody in a room when you are not there?'

Dr Watson added that patient care could suffer because medical care practitioners, with lesser qualifications, could miss vital clues a GP would use to pick up on a serious illness.

Dr Robbie Coull, a GP locum based in Scotland, said the name 'medical care practitioner' was an attempt to make patients believe they were seeing a doctor. He said the Government should have kept the name 'physician assistant' used in the US for similarly qualified staff.

'I think it is very cynical

to take somebody who is a doctor's assistant and then call them medical care practitioner.'

Dr Gareth Hayes, a GP in Cardiff, said there was little difference between medical care practitioners and nurse practitioners, who were 'slower and less decisive' than GPs.

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