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At the heart of general practice since 1960

...He should be applauded, not subject to a witch-hunt

Government opens door to private firms and reveals tougher target for GP commissioning ­ by Daile Pepper

Every GP will be expected to take on practice-based commissioning by the end of 2006 under a dramatic Government move to speed uptake of the scheme.

Ministers revealed this week the target for GP involvement would be brought forward by two years as part of its latest round of wholesale reforms to NHS structures.

The plans, outlined in Commissioning a Patient Led NHS, state that the Department of Health 'expects to see PCTs make arrangements for 100 per cent coverage by the end of 2006'.

To entice GPs, PCTs will take on the management and 'back-office' work involved in commissioning to alleviate the administrative pressure on practices.

GPs will also be able to take on commissioning 'to a greater or lesser extent' according to their wishes, the document states.

A source close to ministers said the aim was to 'remove every excuse for GPs as to why they are not doing it'.

PCTs have been given strict deadlines to get GPs on board and come up with plans to change their own role in the NHS from providers of services to commissioners.

The changes come on top of Government demands, revealed by Pulse, for quality framework rewards for practices that take up commissioning.

But GPs said the latest proposals would make no difference as PCTs were not being given extra cash to take on the administrative work. There are also no direct penalties if practices refuse to sign up.

Dr Hamish Meldrum, GPC chair, said the lack of additional resources meant GPs would take no notice of the 2006 date.

He said: 'It's all very well to bring the date forward but without further resources it's not going to happen.'

Dr Chaand Nagpaul, chair of the GPC's primary care development committee, condemned the Government for 'converting what was a voluntary process into one of enforcement and compulsion'.

Dr David Colin Thome, Department of Health national clinical director for primary care, insisted practice-based commissioning was still voluntary.

'We are just encouraging PCTs to put this higher on their agenda. That is what bringing the date to 2006 is.

'We think there are so many advantages for general practice that we want them involved in some way.'

Dr Colin-Thome added that no extra money was needed for PCTs to take on administration of practice-based commissioning.

He said trusts currently spent most of their money on clinical activity and this would lessen with the change in their role.

The Government plans will also mean a cut in the number of PCTs and strategic health authorities in order to deliver £250 million-worth of savings for the NHS.

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