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Solicitor Daphne Robertson looks at matters relating to lease liability, an important consideration for GPs who rent their premises

Solicitor Daphne Robertson looks at matters relating to lease liability, an important consideration for GPs who rent their premises

By Ian Cameron and Rob Finch

The Government plans to promote ‘self-care' as its flagship solution to rising demand on health care services.

Encouraging patients with minor ailments and chronic conditions to take more responsibility for their health is described as the ‘next push forward' by officials.

GPs said they were sceptical it would help and pointed out it contradicted the drive to improve access.

With 40 per cent of GP time taken up by self-treatable disorders ministers want to teach patients to help themselves.

Consultations with patients with chronic conditions are expected to develop into a ‘meeting of experts'.

A spokesman for the Department of Health said ‘big rewards' would result from plans which include the launch of a major ‘partnership' programme. It builds on the expert patient programme and taking more drugs over the counter.

‘Approaches that target and co-ordinate resources and prevent crisis episodes decrease GP workloads,' he said.

Dr Dermot Ryan, a GP in Loughborough, Leicestershire, said the objectives were ‘pie in the sky'. Patients may not have the health ‘literacy' to deal with co-morbidities, he said.

‘Government has repeatedly absolved patients of responsibility for health,' he said.

Dr Geoff Wong, a GP in north-west London, said the plans could widen health inequalities and lengthen consultations.

‘I have no idea how you go about implementing an increase in self-care,' he said. ‘If you have to explain basic physiology that takes at least two or three times as long.'

Dr Des Spence, a GP in Glasgow, said few patients would take responsibility for themselves. ‘Anything to move away from a pill for every ill, but I'm sceptical it will have a large effect,' he said.

Primary care tsar Dr David Colin-Thome said designing self-care into practice-based commissioning would create ‘sustainable' benefits.


the rationale

• Surgeries with patients with chronic conditions become a ‘meeting of experts'

• Patients monitor and analyse their own progress on chronic conditions

• GPs become ‘brokers and advisers' to patients with minor ailments

• Improved relations with patients as they learn to use the service appropriately

And the doubts

• Explaining why a consultation is inappropriate could take ‘two to three times as long'

• As minor ailments are filtered out presentations become more complex

• Is the evidence base convincing?

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