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NHS managers have criticised the Government for leaving them in the dark over the Choose and Book initiative and raised serious questions over whether the scheme can work.

PCT directors responsible for implementing the controversial proposals said delays to guidance had left 'more questions raised than answers'.

In a report on PCTs' response to the scheme and preparations to implement it, managers also warned GPs will not 'engage' with Choose and Book.

Only one in five PCTs had started work to assess how the programme, which is due to start by the end of 2005, would change internal practice systems.

The findings come as a further blow to ministers after GPs said they would boycott the scheme unless it was an enhanced service.

GPs' views hardened last week, with Dr Gillian Braunold, vice-chair of the GPC IT sub-committee, arguing that GPs should not participate in Choose and Book even if they were paid for it. She described the Government's plans as 'Alice in Wonderland'.

She said: 'It is absolutely impossible and why should we do it? They are asking us to do even more in a pressured consultation.'

The report by the NHS Modernisation Agency, based on the views of PCT directors who attended its 'masterclasses' on Choose and Book, found concern over how the scheme would integrate with other Government initiatives.

Some directors also said they did not have the

money or the expertise among their staff to implement the scheme.

Dr John Williams, joint chair of the RCGP/GPC IT committee, said the lack of consultation on Choose and Book was embarrassing.

'If I am not informed about what is going on then who is?' he said.

The National Programme for IT said it would 'increase engagement activity' with GPs 'as and when it is appropriate'.

By Cato Pedder

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