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An early demise of PBC would be appreciated

From Dr Neil Tallant

Christchurch, Dorset

Are we GPs really surprised at the current failings in practice-based commissioning (News, July 6)? We have a health minister, Lord Warner, who is telling us to forget the past (News, 29 June), and PCTs that have simply reverted to type by producing top-down plans to suit their agenda of saving money. This combination alone should be sufficient to predict total failure.

The failings of NHS finances are not the result of GP pay awards or clinical activity; they are the result of misguided political agendas that are a direct consequence of not learning from the past.

Political agendas correlate poorly with clinical priorities (remember 48-hour access?). Never has the GP agenda driven PCTs to implement change. Why would anyone (excepting ministers of the realm) expect PBC to be different and work? Even the name is wrong: locality-based may have had a little more credence.

PBC is yet another example of ministers discussing ways to change the colour of the leaves (not to mention dumping the responsibility for failure squarely at GPs' feet) when what the NHS needs is a root, trunk and branch review. An early demise of PBC would be appreciated. GPs could then kick this farce into touch and get back to the day job.

Be brave for once Lord Warner: make a statement admitting that the NHS is cash-limited, that the notion of an internal market is a farce and divisive. Then you could urgently engage with clinicians to manage real priorities for health care.

Political suicide? Probably, but you will be gone in a couple of years – so why not do the right thing for once and make a real difference?

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