The Health service journal
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A survey of primary care initiatives in casualty departments in North Thames found confusion over aims and managerial accountability. Nurses and GPs staffing these projects often overrode the triage decisions made by casualty staff. The schemes lacked the information systems required for a full analysis of costs and benefits.
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A survey of junior doctors in trusts in one English region found the majority did not know whether or not their post met Department of Health requirements on hours and conditions. Most did not know that average hours worked per week should not exceed 56. ⋯ But almost two-thirds of junior doctors were unaware of these. Ignorance of the New Deal by junior doctors and other NHS personnel could hamper accreditation of trusts.
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The white paper will move the NHS towards an insurance model where a capitated budget will be held by a single agency. Public accountability will be weakened by allowing primary care trusts and PFI hospitals to combine the planning and provision of services. Primary care groups could sound the death knell of equity, universal coverage and care free at the point of need in the NHS.