Practices that spend more than their perceived share of a commissioning consortium's allowance on referrals or whose patients spend the money on emergency attendances are likely to come under fire from consortium directors and eventually be expelled.
They may then find it impossible to join another consortium, and be out of business. Meanwhile, the Government can erode the budget for secondary care and GPs will take the blame.
A necessary condition for GPs taking responsibility for commissioning secondary care is that the minimum national spend on secondary care must remain at the same percentage of gross national product that it is now. Otherwise we should refuse to take it on.
From Dr Alick Munro,
Cranford, Middlesex
