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- W21345976 abstract "# Primary care groups and the right to prescribe {#article-title-2}In matters of NHS funding, politicians tend to say one thing and health economists another. Governments commit themselves to the Hippocratic ethic that patients should be treated solely on the basis of need. But economic reality has always required us to make hard choices between deserving patients. Today we require a legal dimension to this tension. This article examines the general practitioner's legal duty to prescribe medicines.The terms of service of general practitioners impose a duty to prescribe on the basis of need. Yet, primary care groups will be expected to operate within a “cash limited envelope.” Is this duty to prescribe dependent on patients' needs or limited by available resources? Will it be lawful to deny access to effective but expensive medicine on grounds of cost? As patients litigate for NHS resources, general practitioners need to know who is to blame when patients are denied access to expensive medicines.What are the rights and duties of general practitioners to prescribe medicines to their patients? Since the start of the NHS doctors have been assured that the principle of legitimate clinical freedom will be preserved. In 1948, Ernest Bevan promised doctors “all the facilities, resources, apparatus and help I can, and then to leave you alone as professional men and women to use your skills and judgment without hindrance.”1 And in the new white paper, the present government “has committed itself to the historic principle of the NHS: that if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.”2But the pressure imposed by scarce resources is not always consistent with political rhetoric. In addition, the proposals to create primary care groups will require general practitioners to manage NHS …" @default.
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- W21345976 date "1998-11-14" @default.
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- W21345976 title "Primary care groups and the right to prescribe Commentary: Bevan's covenant continues intact" @default.
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- W21345976 doi "https://doi.org/10.1136/bmj.317.7169.1361" @default.
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