GENETIC-COUNSELING AND TESTING IN EUROPE

The Genetic Enquiry Centre in Manchester has designed a three-pronged health services research programme to address current issues in geneti cs. The issues are: whether doctors who are not trained in genetics ca n manage the genetic problems they meet in their practice; whether the re are enough resources in specialist centres to cope with current and imminent referrals; and whether providers of primary care recognise g enetic problems and refer patients appropriately. The three studies pr oviding the basis of the programme - the National Confidential Enquiry into Counselling for Genetic Disorders, the Concerted Action on Genet ics Services in Europe and the Primary Care for Genetics Patients stud y - are discussed. The first two provide unique views of genetic couns elling in the UK and of the access to and quality of health services f or patients with or at risk of genetic disorders throughout Europe, an d make recommendations based on their findings. The third is a continu ing study that aims to determine the effects of patterns of referral a nd care in the different healthcare systems in Europe. Although it is unlikely that there will ever be enough medical geneticists to cope wi th the consequences of genetic advances on health services that are la rgely unprepared, specialist genetic centres are the natural core reso urce for future multi-specialty genetic services. This will give clini cal geneticists an extended role complementary to that of diagnosing r are syndromes.