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GP-led centres - who's in the lead?

It would be fascinating to be a fly on the wall during one of the Department of Health's branding meetings.

It would be fascinating to be a fly on the wall during one of the Department of Health's branding meetings.

The names of key initiatives - from Choose and Book to Care Closer to Home - are carefully chosen marketing tools, designed to be catchy, memorable and capable of instantly summing up a policy's purpose.

Which is why the term GP-led health centre is so instructive. It's deliberately dull, purposefully GP-friendly and far less divisive than the term polyclinic, which ministers initially used.

Just how GP-led these centres really are, though, is a matter for debate.

As Pulse revealed last month, they are set to employ three nurses to every GP, so in one sense at least they are not very GP-led at all. And the suspicion was that when it came to winning the tenders to run the centres, GPs would be shoved aside in favour of private companies with bid teams and fancy Powerpoint presentations. Dr Richard Vautrey, deputy chair of the GPC, was among those who predicted the vast majority of Lord Darzi's centres would be run by the private sector.

As it turns out, he was wrong. Credit started to crunch, investors got nervous and the expected rise of the private sector somehow failed to materialise. And there is more to the story too. GPs were warned to adapt or die - and with typical dexterity, adapt many GPs did.

Seven of the first nine tenders have been won by GPs, Pulse reveals this week, although many of those victors may not be recognisable as traditional family doctors. Indeed the success of general practice in the tenders so far raises some interesting questions.

For starters, where does a GP end and a private company begin? Many of the winning GPs and practice consortiums are so business-minded and entrepreneurial that they are regarded with suspicion or even downright hostility by their local colleagues.

And then again, were GP leaders right to have regarded GP-led health centres as such a threat, if it is to be GPs who end up running them?

For the answer to that, here's another statistic we uncovered this week.

It turns out the centres are likely to be funded at twice the level per patient as neighbouring practices. With that kind of disparity, GP-led health centres will stir up and destabilise general practice, as they were always designed to do. Much better run by GPs than private firms, maybe, but GPs must be wary of embracing a Trojan horse.


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