Children are different. It is 30 years since the Royal College of General Practitioners published its policy ‘The Care of Children’1 (in response to the Committee on Child Health Services' Fit for the Future).2 The policy largely supported Donald Court's ideas to improve the care of children, but it balked at the new concept of a primary care paediatrician. However, the idea has not gone away and still forms an integral part of the strategic direction for the Royal College of Paediatrics and Child Health (RCPCH).3 They point to the role such consultants have in much of Europe and the US, dealing with the acutely ill child, and the lack of formal paediatric training in a third of GPs. Yet, 34 million consultations with children are carried out by GPs each year, and our record on preventative measures, such as immunisations, is excellent. The RCPCH needs to double the consultant workforce just to deliver a consultant-led service, let alone deliver a comprehensive primary care service. Indeed, general paediatric consultant numbers have risen by only 7% per annum between 1999 and 2003, with community paediatric posts remaining static.4 Therefore, GPs will continue to be responsible for the care of this vulnerable group for years to come.
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