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Lansley poised to scrap PCTs and make GP commissioning compulsory

By Ian Quinn

Primary care trusts are due to be scrapped altogether under health secretary Andrew Lansley's health White Paper, which will make it compulsory for GPs to take on commissioning, according to reports today.

Briefings with parliamentary insiders lead several of today's newspapers to predict Mr Lansley, who has already signalled his intention to scrap strategic health authorities, will also phase out England's 150 PCTs as GPs take over the reins of the £80bn NHS budget.

The massive restructure of the NHS is said to have the personal backing of David Cameron, helping Mr Lansley win a battle of wills with the Treasury, which had expressed doubts over his plans.

As well as commissioning being made compulsory, the reports say Mr Lansley has promised the Chancellor George Osborne there will be 'tough accountability measures' in place to hold GPs to account for their spending decisions.

The White Paper, due out on Monday, will lead to a massive round of NHS manager redundancies and will also pave the way for GPs to take over responsibility for the commissioning of out-of-hours services.

Mr Lansley has encountered opposition from some leading GPs, who have urged the health secretary to scale back his plans.

The NHS Alliance, which represents GPs and NHS managers, called for Mr Lansley instead to launch GP commissioning via a series of national pilots, claiming the vast majority of GPs are not ready to take on responsibility.

However, other groups, including the NAPC, are more strongly behind Mr Lansley's plans and have called for GPs who are either unwilling or unable to effectively take on commissioning to be phased out.

NAPC executive member, Dr Charles Alessi, told Pulse he welcomed plans which would provide the ‘prospect of liberation from the micromanagement and inhibition of any attempt at innovation over the past years.'

The GPC has also thrown its weight behind plans for GPs to take on commissioning. However, it could be set for a huge battle with the Government over proposals to make it compulsory, with the recent LMCs' conference overwhelmingly backing a motion that while GPs should lead commissioning, any such move should be voluntary for practices.

Reports of the death of PCTs will spread what is already a state of virtual panic in NHS management circles, with senior figures, including NHS chief executive Sir David Nicholson, casting huge doubt on the ability of GPs to take on commissioning.

There has been speculation Mr Lansley aims to create around 50 health authority organisations which would take on the role of policing GP spending and driving the public health side of national policy.

A spokesperson for the Department of Health said: ‘In recent speeches, the Health Secretary has set out the values and vision for an NHS centred on patients; we will ensure that patients share in decisions about their care - "no decision about me, without me".

'He has already emphasised the need to liberate the NHS to focus on outcomes and improving results for patients, as reflected in the revised Operating Framework which was published on the 21 June 2010.

‘And in a speech to the BMA on 2nd July, he highlighted the importance of empowering doctors and nurses in the NHS to deliver quality standards and services.'

In depth

Read what the national newspapers are saying about the planned expansion in GP commissioning

All the latest news and comment from Pulse on the imminent changes to GP commissioning

Andrew Lansley meeting with GPs and nurses in Cumbria yesterday Andrew Lansley meeting with GPs and nurses in Cumbria yesterday What does GP-led commissioning mean for you?

Attend the NAPC Conference on 20 and 21 October in Birmingham for an outline and post-election analysis of the new coalition Government's key health policies, with stimulating expert debates on key issues facing primary care over the next five years.
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