Respiratory sequelae of whooping cough. Swansea Research Unit of the Royal College of General Practitioners.

Eight hundred and thirteen children who had had whooping cough when under 5 years of age in the 1977-9 epidemic were compared with a control group roughly four and a half years later, each child being matched by age and sex and from the same class in school. The index group showed long term respiratory sequelae of whooping cough--namely, deterioration in lung function, increase in respiratory symptoms, and increased admission to hospital for both upper and lower respiratory conditions. Asthma was significantly more common in the index group, suggesting that asthma was being regarded as a contraindication to pertussis vaccination. Only 3.5% of the asthmatic children in the index group had been vaccinated as against 29.1% of the controls.     

Patient care and the general practitioner. Joint Working Party of the Welsh Council of the Royal College of General Practitioners and the Welsh General Medical Services Committee.

The role of general practitioners is being redefined in the light of the emphasis on more care in the community, economic factors, and patients'' expectations. The strength of general practice lies in the doctor-patient relationship; this strength must not be lost sight of. Specific tasks of the general practitioner include the responsibility for the care of individuals; the role of gatekeeper; broad knowledge of curative, preventive; and rehabilitative medicine; teamwork; management; and development of population based strategies. Future work patterns include the general practitioner first and foremost as a clinician and an integrator of health services, but they also involve audit, education and training, research, management, and relations with organisations in the public, private, and voluntary sectors. It is important to make changes only when they benefit patients and to maintain the principle of equity of access to care.