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GPs’ commissioning role puts conflict of interest at heart of NHS, says Burnham

The role of GPs in CCGs ‘enshrines a colossal conflict of interest at the heart of the NHS’, the shadow health secretary has told Pulse.

Speaking at a mental health conference on Thursday, shadow health secretary Andy Burnham said this is why Labour would take away GPs’ commissioning remit, as a key step towards addressing what he sees as the most damaging market-driven aspects of the NHS reforms introduced through the Government’s Health and Social Care Act.

Mr Burnham has pledged to hand health budgets over to health and wellbeing boards, resulting in shared responsibility between local authorities and the NHS – part of Labour’s new vision to incorporate all aspects of health and social care into one budget and deliver care to the ‘whole person’.

He told Pulse the move would not prevent GPs from having a key role in shaping services locally, but would be necessary to prevent erosion of public confidence in the NHS and the profession itself.

He said: ‘I think GPs were sold a false prospectus  - they were not being given what they were promised.

‘But there’s a bigger problem – the Act enshrines a colossal conflict of interest at the heart of the NHS. GPs are providers and it’s a difficult – almost impossible – thing to be both.

‘It places GPs in an invidious position that undermines public confidence.’

Mr Burnham said CCGs could be ‘refocused’ to become an ‘implementation body’, so that clinicians could still redesign services but without blurring their roles as providers.

He said: ‘Now that we’ve got this vision, it will be about how clinicians go about rebuilding services in their area to make them integrated, home-based, “whole-person”, but it isn’t visibly funding one rather than another operation – because in the end that will undermine the profession.’

Burnham, who was speaking at a conference held by the University of Chester Centre for Psychological Therapies in Primary Care, said his broader plans involve a ‘radical rethink’ of the system to link up social care with the rest of the NHS and deliver ‘whole person’ care.

He anticipates this will mean GPs taking on a more proactive role in coordinating all aspects of their patients’ health and social care needs.

He said: ‘I’m thinking of a new vision of general practice for “whole-person” care, where if GPs were offering a social rather than a medical model of care, maybe they would be providing better solutions for people that would save a lot of money.’

‘If they were able to spend public money in a much broader range of ways and sometimes prescribe more social rather than medical interventions, wouldn’t that empower general practice? That’s where my thinking is going.’

Readers' comments (12)

  • Bob Hodges

    "Mr Burnham said CCGs could be ‘refocused’ to become an ‘implementation body’, so that clinicians could still redesign services but without blurring their roles as providers."

    To be fair that's not a bad point.

    Our local CCG is doing so good work around service design, which is where the greatest impact for good can be had. The COI thing is managed better in some CCGs thta in others.

    By making the NHS the provider of default, COIs can be further reduced.

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  • Well, several practices in my locality tried to start up a intermediate service to reduce referral and also to imrpove convenience for our patients by having GPSIs and consultants coming to our practice.

    We were told of so many hoops we had to jump through, including having to involve local hospital/private service if they want to bid, CQC registration etc etc we just gave up in the end. CCGs are now more worried about their legal responsibilities (rightly so!) then clinical benefits they have reverted to their former body (called PCT!)in their stance.

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  • You've got to laugh, haven't you?

    All the work over many years and it's going to be all scrapped in a couple of years.

    You have to wonder why we all bother. .

    PS - can any of you remember that fundholding thingie?

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  • David Bush

    "The role of GPs in CCGs ‘enshrines a colossal conflict of interest at the heart of the NHS’, the shadow health secretary has told Pulse."
    Compare and contrast this statement with the following:
    "The role of MPs in parliament enshrines a colossal conflict of interest at the heart of central Government."

    Am I missing something, or is just that politicians are inherently trustworthy whilst GPs are only interested in feathering their own beds?

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  • Someone should have bought up this conflict on interests well before the act went through parliament, then Mr Burnham and his colleagues in parliament could have debated it and come up with a solution......

    Oh wait...... it was highlighted? ..... And they just ploughed on anyway? ......

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  • Let me tell you a FACT, GP commissioning is a FARCE, ask grass root GPs/ Locums, they don't even know what the commissioning is, whether they have any say or not? Its again the MANAGERS who are running commission with million pound salary, DOOM for NHS

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  • 9.11 - don't blame MANAGERS. Someone has to do it ! But I do agree it's a farce. Same people doing the same jobs but for more organisations.

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  • David Bush

    If grass roots GPs do not know what is happening in commissioning perhaps they should make enquiries. It is now part of the job.

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  • Bob Hodges

    Many Grassroots GP and locums don't even know how to run a business because they aren't partners or they rely on a practice manager or a small group of partners to do all the 'boring stuff'.

    Commissioning IS working well in places, and it doesn't need to be a majority activity, as long as those that do it, do it well.

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  • GPs should stick to what they do best - primary care. The idea that they can organise secondary care services is a joke - that should be left to secondary care. These reforms were always about introducing a new healthcare market and increasing NHS privatisation. GPs have been mugged along with the rest of us

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