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Even the keen pass up commissioning

Even the most enthusiastic GPs are giving up on practice-based commissioning because of heavy-handed implementation of the scheme by PCTs.

GPs are reporting a host of constraints being put on what they can do, including restrictions on keeping savings and being forced to sign up to onerous 'accountability' agreements.

GPs said they were being 'bogged down in detail' and having to endure protracted negotiations just to get started.

Dr Paul Roblin, chief executive of Berkshire, Buckingham-shire and Oxfordshire LMC, said PCTs in the region were turning commissioning into a quality framework-style points scoring system. He said: 'Objectives should be process-driven not outcome-driven. If it is too on-

erous practices will walk away.'

Dr Fay Wilson, secretary of seven north-west London LMCs, said GPs' enthusiasm had been 'stymied by PCTs at every turn'.

She said: 'People will say ''we'll put our effort in where we're going to get a return''.'

In the most debt-ridden

areas, such as Bristol and

York, GPs have been forced

to give up their right to keep 70 per cent of savings they make.

But Dr Michael Dixon, chair of the NHS Alliance, condemned a 'defeatist' attitude among GPs and PCTs. He said: 'The sense of defeat among practices and PCTs gets to me. There seems to be incomprehension as to why we should be bothering.'

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