Centrally funded scheme would not necessarily be better

Editor—The conclusions of the report by the West of Scotland Postgraduate Medical Education Board on general practitioners' attendances at postgraduate education activities are open to debate.1 The implied assertion that a centrally organised scheme is better than an open and free education market (working to professional standards) requires more evidence. After all, one of the most important reasons for introducing the postgraduate education allowance was to encourage personal responsibility for learning and development in general practice education and a move towards the concept of the purchaser-provider partnership.

Despite some of the limitations of the postgraduate education allowance, many exciting methods of education are now available to general practitioners. Distance based learning programmes, practice based educational activities, personal education plans, and portfolio learning now dominate continuing medical education and professional development. In addition, through the postgraduate education allowance system, skills have increased among a wide variety of providers, not all of whom can be tarred with the brush of promotional greed. A centralised system of education, as reported in the west of Scotland study, sounds like a minor variation of what was available before the postgraduate education allowance came into effect; that system was centrally directed, poorly attended, and, generally, irrelevant.

The more worrying conclusion of this study is that, somehow, when general practitioners choose an educational activity outside the central scheme, they do so purely for financial gain. This hints at a strange belief that people in the “centre” know better what is good for general practitioners than they do themselves. If that is the case then we need to clarify our commitment to the adult learning model, which has been the main plank of criticism (at times unfairly) of the postgraduate education allowance system. Either we genuinely believe in this model and respect the professional integrity of our …