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At the heart of general practice since 1960

Hypertension polypill beats drugs used singly

A rift is growing between out-of-hours organisations over the preferred model for the future of out-of-hours care.

More GP co-ops have now endorsed the alternative model of 'collaborative medical services' (CMEDS), instead of the Government-backed 'com- munity benefit society' (CBS) model.

The 'father' of the GP

co-operative movement, Dr

Krishna Korlipara, created the CMEDS model, which would give GPs overall control of services, because of concerns over patient care and the involvement of other health professionals under the CBS model.

The CBS model was launched earlier this year by the Department of Health, the National Association of GP Co-operatives (NAGPC) and think-tank Mutuo.

GP co-op Thamesdoc in Surrey has now endorsed the CMEDS model and said it was reconsidering its membership of the NAGPC because of its concerns. Dr Korlipara already claims support from South East London Doctors on

Call as well as his own co-

op Bolton District Medical Services.

Dr Michael Crow, Thamesdoc's medical director, described the CBS model as a 'mistake' that would involve too many 'disparate' agencies and 'stifle innovation'.

He said: 'It will be a giant organisation with multiple committees. GPs are the people who know the most about out-of-hours but as part of a CBS will be tied up in red tape.'

Preston Primary Care Centre Ltd was also concerned about increased bureaucracy and said it would be 'reassessing' its membership of the NAGPC.

Chair Dr Richard Parry said: 'You can see yourself sitting in committees rather than having a group of close-knit GPs sorting out problems.'

South Lancashire LMC chair Dr Ruban Prasad said the 'very principle' of the CBS was wrong. 'GPs must remain at the vanguard of the management process,' he said.

'If it's not up to standard we could see a deterioration of care.'

Dr Korlipara presented his model at the 10th anniversary dinner of North Staffordshire Medical Services. He claimed there was a 'huge ground-swell' of support.

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