Child: care, health and development, 1983, 9, 245.

Editorial

MULTIDISCIPLINARY PRIMARY CARE

This journal is multidisciplinary — how can this concept be related topractical paediatrics in primary care?

The problem is a fascinating one and a solution in the next decadeor so would be fulfilling to all those involved. These include the familydoctor, the paediatrician and the community physician, the healthvisitor, the social worker, the physiotherapist, the speech therapist andeducationalists, not to mention voluntary and self-help groups.

What a long list! Every member of the population has a generalpractitioner (a privilege and a responsibility); he or she has 24-hourobligations and the records of all occasional outside consultations aresecurely held at the surgery.

This train of thought leads along the line that the family doctor isthe natural hub of all the other influences listed above. The G.M.S.Committee and the Royal College of General Practitioners believethat the family doctor should be the key person in developmentalsurveillance as well as in the treatment of illness; but there is littledoubt that major improvements are needed in communications to andfrom that family doctor.

Who should be the catalysts in these desirable changes? Those withthe purse strings perhaps (the District Health Authority)? Money willbe very short but the first need is for an improvement in communi-cations. Shared premises make this easy - the paediatrician has ahealth visitor sitting in and he or she can walk along to the dietician,the pathology laboratory or the well filled library. The general prac-titioner is more isolated but surely the community physician (paedia-trics) could ensure that all the above important specialists can talkeasily to one another.

The patient is the raison d'etre for all these well intentioned peopleand the teacher or physiotherapist can be the really benign and keyfigure if he or she is available when the child in need has the 'windowopen'.

SYDNEY SCOTT29 Piercing Hill, Theydon Bois,

Epping, Essex CM 16 7JW

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