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The survey of 155 GPs showed that 47 per cent of GPs wanted obesity to be dropped. A quarter wanted learning difficulties and chronic kidney disease removed from the framework. Twelve per cent rejected the smoking indicators.

Scottish LMCs voted in April 2007 for obesity to be dropped from the quality framework because it is a lifestyle issue.

The survey also highlighted that 34 per cent of GPs wanted changes to the way in which the quality framework deals with obesity, if it remains an indicator.

Hertfordshire GP Dr David Haslam, clinical director of the National Obesity Forum, described the obesity domain, worth eight points and introduced in 2006/7, as ‘worse than useless.'

'I sympathise with the GPs who want obesity to be dropped, because the current indicator is of no clinical benefit at all. All it does is elevate all obese patients to the same status,' he said.

GPC deputy chairman Dr Laurence Buckman said that the indicator for obesity was a meaningless device that was included in the quality framework simply to please politicians.

'It is the only indicator in the quality framework that is not supported by clinical evidence,' he said.

Dr Haslam said that it was essential that obesity remained in the quality framework.

'We need to be screening the patients on the obesity register for diabetes, hypertension, stroke and heart disease,' he said.

'Patients can then be moved from the obesity register to other clinical registers, such as diabetes.'

'There is a 100-fold increased risk of diabetes in individuals who have a BMI of 35 and over.'

The survey found that GPs believed that obesity was a social problem and not a medical one that GPs could effectively treat.

Dr Haslam, however, disagreed saying that it was important for GPs to be involved in obesity so that they could pick up other conditions.

'It is important for our sanity; we don't want an epidemic of obesity on our hands,' he added.

The survey also showed that a quarter of GPs wanted depression, worth 33 points, to be dropped from the quality framework, with many unhappy about the validity of the questionnaire used to detect it.

Dr Ian Walton, chairman of Primary Care Mental Health and Education (PRIMHE) and a GP in Sandwell, West Midlands,

said that it was notoriously difficult to measure depression consistently and agreed that the tools that GPs had to do this were not good enough.

But chief executive of PRIMHE Dr Chris Manning said: 'Take depression out of the quality framework and you take out some of the most crucial work that GPs need to be doing.'

sanjay.tanday@haymarket.com

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