The Journal of the Royal College of General Practitioners
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The further increases in National Health Service (NHS) patient charges introduced on 1 April 1985 represent a continuation of the Government's policy of requiring all except priority groups to pay an increasing proportion of the cost of their own treatment. Reductions in the use of the services on which charges are imposed would be incompatible with the stated objectives of the NHS. An analysis of the published data on NHS prescription dispensation shows that this policy has been associated with a considerable reduction in the per capita consumption of prescribed drugs in non-priority groups.
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As part of wider review, this study examines the pattern of referrals to the emergency bed service from seven selected health districts in London over a six-month period. A 12-fold variation in the use of the emergency bed service was found between the different districts. Half the referrals to the service were made by doctors working in deputizing services, less than 1% of referrals were due to inter-hospital transfers and half the referrals were made by general practitioners. ⋯ Almost three-quarters of the respondents did not use the emergency bed service. Wide variation between the different health districts was again demonstrated. In spite of the variations described, the survey revealed a continuing demand for the service by general practitioners.
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From a retrospective study of hospital records, it is calculated that the present incidence of rheumatic fever in Scottish children is 0.6 per 100 000 per year. This is in keeping with recent research from other developed communities. An attempt is made to assess the relative risk of developing rheumatic fever after antibiotic-treated streptococcal sore throats and non-antibiotic-treated streptococcal sore throats. The risk in both cases is low (probably in the order of 1:30 000) and there is no evidence that prescribing antibiotics for prodromal sore throats confers benefit.