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GPs battle to cut back on PCTs in the capital

By Ian Cameron

GPs in London are to fight plans to keep the same number of PCTs in the capital.

The London GP Forum is arguing that failure to cut the number of trusts will ruin an opportunity to develop better commissioning models and care pathways, particularly for patients from minority ethnic groups.

Keeping the 31 borough-based PCTs would also entrench duplication of management roles, GPs claimed.

The forum, a grouping of London LMC representatives, is planning to take GPs' case to the London Assembly and other political forums.

Dr Rob Hughes, chair of the forum and a GP in Greenwich, south-east London, said there should be between five and 10 PCTs across London: 'Certain things need to be commissioned across all 32 boroughs and for very rare and expensive conditions sharing risk across a larger area makes a lot of sense.

'The cozy relationship between small PCTs and hospital trusts in deficit has been compounded by smallness.'

Dr Stewart Drage, joint chief executive of Londonwide LMCs, said GPs were 'gobsmacked' when plans revealed no reduction of PCTs. PCTs were not fit for purpose in their current structure, he added.

'London's a complicated city and GPs have been able to see what these problems are over a long period of time and continuing with existing PCTs is unlikely to resolve these issues.'

Dr Richard Lewis, a senior fellow in health policy at the King's Fund, agreed the proposals not to cut the number of PCTs 'stuck out like a sore thumb'. But he said there was little evidence to show that bigger was better.

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