Britain: An official handbook > 1977

SOCIAL WELFARE
PRIMARY
HEALTH CARE
Practitioner
Services
Home Nurses,
Midwives and
Health Visitors
Group Practices
and Health
Centres
HOSPITALS AND
SPECIALIST
SERVICES
131
Primary health care, the front line of the personal health services, is in the
hands of doctors, dentists, opticians and pharmacists working within the service
as independent practitioners, and home nurses, midwives and health visitors
employed by the health authorities.
The family practitioner services cover the services given to individuals by
doctors, dentists, opticians and pharmacists of their own choice. They are
administered by family practitioner committees established by the health
authorities and boards. In Northern Ireland the family practitioner services are
administered by the Central Services Agency.
Some 24,500 general medical practitioners (principals and assistants) in
Great Britain take some part in the service. The maximum number of patients’
names permitted to be on a family doctor’s list is normally 3,500; the average
number in Great Britain is about 2,400. In Northern Ireland there are some 740
general practitioners with about 2,100 patients each. Access to most other
parts of the health service is obtained through the family doctor.
There are over 13,200 dentists taking part in the health service.
Some 1,000 ophthalmic medical practitioners and about 6,500 ophthalmic
and dispensing opticians are engaged in the general ophthalmic services which
provide for the testing of sight and provision of spectacles. Patients requiring
treatment are dealt with through the hospital eye service.
There are about 13,000 retail establishments under contract to the National
Health Service with responsibility for the dispensing of all prescriptions
except for the small number dispensed by certain general medical practitioners
and hospital pharmacies.
Health authorities are under a duty to provide home nurses, midwives and
health visitors, to meet the demand of patients. Home nurses attend to people
needing nursing in their homes or elsewhere outside hospitals. Midwives assist
the family doctor at home confinements (about 6 per cent of all confinements),
and care for mothers and babies (whether born at home or in hospital) for about
10 days after the birth. Health visitors are concerned with the health of the
household as a whole, and have an important part to play in health education
and preventive measures. They work in close co-operation with general medical
practitioners, the paediatric and geriatric wards of hospitals and social workers.
Increasingly family doctors work as members of co-ordinated primary health
care teams. About three-quarters of them are in partnership or group practices,
and it is becoming more common for home nurses, midwives and health visitors
to work from the larger premises established for such practices. Nearly a fifth
of the doctors work in 830 health centres which are built and maintained by
the health authorities and which provide modern and well-equipped accommo¬
dation for primary health care teams consisting of general practitioners and
home nurses, midwives and health visitors. Additional services which may be
provided at health centres include dentistry, chiropody, family planning, ante¬
natal care, health education and sessions for children. Occasionally, when
necessary, provision is made for general ophthalmic services. In some cases, a
social worker is attached to or co-operates with the primary health care team.
Out-patient facilities for local hospitals may also be provided.
The hospital and specialist services provide hospital accommodation of all
kinds, including district general hospitals with treatment and diagnostic facili¬
ties for in-patients, day-patients and out-patients, hospital maternity depart-