ABSTRACT
This chapter discusses the four issues: how the primary care service is currently managed, the ethical issue of the reallocation of resources, priority setting, and whether the proposed new services are necessary in the long term. It also discusses that these four issues need to be considered by each practice or group of practices, but new personnel most likely to be employed will be physiotherapists, psychologists, dieticians, chiropodists, and counsellors. In primary care there must be a move away from services that are solely general practitioner led, to multi-professional partnerships. One particularly useful new, or additional staff member is a completely new post–that of practice pharmacy manager. Health commissioning could involve the integration of all services including public health, education and social service, and so require a much greater integration of resources and management of people. The need to work with a greater range of health care professionals must be seen as enhancing the general practitioner's role, not as a direct threat.
