GPs must police struggling colleagues under NHS revamp, says Lansley

By Gareth Iacobucci

GP consortiums will be expected to closely police struggling peers to ensure proper accountability under the Government's extensive overhaul of the NHS, according to health secretary Andrew Lansley.

Speaking at a Health Select Committee meeting yesterday, Mr Lansley said the changes outlined in the Government's health White Paper would make accountability measures ‘simpler and more direct' and concerns from committee members that GPs would escape scrutiny under the new system were unfounded.

He said GP consortiums would be expected to exert pressure on colleagues who are not performing, citing the example of some single-handed and small practices, which he said lacked adequate support at present, but would be monitored more closely under the new system.

He added that the White Paper made it clear that the decisions of GP commissioners would be held to account through local authorities, with any disputes between the two referred to the Independent Reconfiguration Panel.

‘Proactively, local authorities will be involved. It is going to be simpler and more direct,' he said.

‘There is a fair point about GP accountability. But this will help to strengthen this, through peer review. There are many single-handed and small practices that are popular with patients, but often are lacking support or a clinical governance network. I believe peer review through consortia will allow this to happen.

‘This is where commissioners will have a much better idea of their responsibilities.'

Mr Lansley said GPC chair Dr Laurence Buckman was right to assert that he ‘won't be a softy' in his new role of secretary of state, but was adamant that he would 'avoid prescribing how [GP consortia] do their business'.

The health secretary also rejected fears from the committee that the pace of change for implementing the reforms was too steep, saying that the plans would not spell ‘organisational upheaval' for GPs.

‘If you're working in a GP practice, this isn't a big change. The change is empowerment,' he said.

‘We are not starting with an evidence-free base. We have Practice Based Commissioning, and evidence from physician-led activity around the world. In PBC, we have structures, people and relationships which are a basis to put this together.'

He added: ‘My conversations with many GPs are that they are ready to do it. If we wait any longer, we are going to have to achieve very substantial savings in management costs at the same time [as reforming].'

Mr Lansley added that claims that handing commissioning budgets to GPs would lead to a privatisation of the health service, made vociferously by the likes of shadow health secretary Andy Burnham, were ‘completely misleading'.

‘This is public money, commissioning public services, for the public,' he said. ‘This is not a privatisation.'