Well woman care: whose responsibility?

GENERAL practice primary care teams are taking more lJresponsibility for preventive medicine and there is evidence that patients welcome health promotion activities on the part of their general practitioner. ' Already, in some districts, as little as 5% of pre-school child health services are provided by clinical medical officers2 and, although opinions about this vary, there is general agreement that this trend is desirable. There is much less consensus, however, that it is beneficial or desirable to transfer family planning and well woman services to primary care teams. The involvement of the community health services in family planning also varies widely. In the City and Hackney Health District there are 36 family planning sessions per week, excluding domiciliary services, and there were a total of 20 586 attendances in 1983. Family practitioner committee returns show that for the same year a quarter of general practitioners in the district did not offer coil fitting and several doctors made no claim for family planning services.