Clin Med
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The regular meetings of the chief medical officers (CMOs) from the European Union's (EU's) 27 Member States provide an important forum to address issues of common interest affecting Europe's populations. Yet there is no universally agreed role for a CMO. ⋯ Four broad categories of countries were identified: those whose CMO is the most senior doctor in the health ministry, in some cases with responsibility spanning all of government; where they are head of a division within the health ministry; head of a separate body such as a national board of health; and countries where no single individual can be identified. Although the diversity of health systems means that these roles cannot be harmonised, there is scope to explore what can be learnt from the different approaches.
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There have been considerable changes in the NHS, medical science and practice in the last 25 years. This article describes the developments in general practice over this period. The increase in the primary healthcare team members and the improved premises from which they now practise has revolutionised primary care. Issues of considerable influence have been the movement of care once provided in hospitals into primary care, the use of computers, new technologies, enhanced training, changes in the demographics of the workforce, the hours general practitioners work and commissioning.
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Workforce planning in medicine is at best an inexact science and at worst a dark art. Over the past year it has become clear that several forces influencing the consultant physician workforce are coming into play at the same time. Many of these forces cannot be easily controlled, but their effects are predictable and thus can be prepared for. Recommendations are made as to how the issues raised should be addressed.