By Ian Quinn, Gareth Iacobucci
Exclusive: GP leaders are to tell the coalition Government they cannot fully embrace its proposals for GP commissioning after admitting the BMA is riven with divisions over how to respond to the white paper.
After a long debate last week, the GPC decided the views of its members were too polarised, and fears of the potential pitfalls too acute, to justify handing health secretary Andrew Lansley the backing he wanted.
Instead, although it will applaud the direction of travel of giving GPs control over commissioning budgets, the GPC's official response to the Government consultation will set out key areas of concern.
LMCs across the country have also been unable to come to consensus over Mr Lansley's plans (see right), with many planning to submit separate responses to the consultation, which ends on 11 October.
The GPC will say it backs plans to put GPs in the driving seat on commissioning but will demand answers to a set of outstanding concerns, including:
- lack of detail about managerial support for GP consortia
- GP consortia being saddled with debts from failing PCTs
- GPs being locked into long-term deals with private firms, including PFI agreements.
Dr Chaand Nagpaul, lead negotiator on commissioning, said the GPC had a ‘host of concerns' that needed addressing before it could back the plans.
‘The white paper is both an opportunity and a threat,' he said. ‘It's strong on ideas but weak on detail. The realities will only come to life once these questions have been answered.'
Dr Nagpaul said it was proving a testing time for the GP leadership, with the proposals splitting opinion at the GPC. Pulse has been told by senior BMA members the divisions are even deeper at wider BMA level.
‘It's a time for responsible leadership and I'm sure the BMA will rise to the challenge,' said Dr Nagpaul. 'We have to represent the different sections and on something as wide-ranging as the white paper there were always going to be divisions.'
Fellow negotiator Dr Beth McCarron Nash, said: ‘We had a very full debate on the white paper. Some people are positive, others have concerns. We must remember nothing has been decided.'
LMCs across England have been holding meetings on the plans, some with well over 150 GPs in attendance.
Dr Jane Lothian, secretary of Northumberland LMC, said GPs were torn. ‘In terms of concept, we are extremely positive. The thing we are concerned about is the destruction of SHAs and PCTs. As much as we love to spar with them, everybody has work-ed very hard to get the system working. We're very concerned organisational memory will go.'
Dr Nagpaul said the Government would find it hard to hit its proposed timetable. ‘The Government will need to act very fast after the consultation to clear up these issues,' he said.
Dr Jane Lothian Countdown to commissioning… are you prepared?The clock is ticking with just over two weeks to go until the end of the consultation on the health white paper, Liberating the NHS: commissioning for patients. Yet there is still a huge amount of uncertainty within the healthcare community, with questions being thrown up around the work and responsibilities that will be involved in the ‘new' NHS.
Come to the NAPC Annual Conference to hear from Andrew Lansley, secretary of state for health and help answer your pressing questions.
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