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The Government's Choosing Health White Paper puts public health at the heart of primary care with profound repercussions for GPs. Pulse looks at the implications

GPs could be held responsible for ensuring their overweight patients slim down under Government plans to shoehorn obesity management into the new GMS contract.

The White Paper on public health outlines proposals to set up enhanced services for obesity management or include it in future drafts of the quality and outcomes framework, as previously predicted by Pulse (September 27).

GPs may be expected to regularly monitor and advise obese patients and to target patients with drugs, prescriptions for exercise or referrals for surgery.

GPs are divided on the issue, with some keen that obesity management be included in the quality framework but others condemning the 'medicalisation of a social problem'.

Dr David Haslam, vice-chair of the National Obesity Forum and a GP in Hertfordshire, thought the plans did not go far enough. 'The current version of the contract is a catastrophic cock-up. We had the chance to do something about obesity that would have really given the right message.'

But Dr Peter Brindle, Wellcome training fellow in health services research and a GP in Bristol, said that if obesity was included in the quality framework the Government would be 'dumping a social and public health issue on the door step of primary care'.

Dr Brindle said including obesity in the framework would mean drawing up obesity registers, a move likely to alienate patients. But he welcomed plans to enable GPs to prescribe exercise.

What the paper says on...


·GMS contract to tackle obesity as a condition in its own right

·NICE to prepare guidance on obesity prevention, identification and management by 2007

·Restriction on advertising salty and fatty foods and drinks to children

·Targets for reducing sugar and fat in foods

By Cato Pedder

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