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Independents' Day

How general practice would look under a Conservative Government

Dr Paul Charlson, chair of the Conservative Medical Association, reports from last week's party conference and explains what a Conservative Government would mean for GPs.

Dr Paul Charlson, chair of the Conservative Medical Association, reports from last week's party conference and explains what a Conservative Government would mean for GPs.

This was the last conference before the election and it was an important one.

The polls show the Conservative Party well ahead and most trusted on public services. Clearly whoever is elected has a difficult task.

Andrew Lansley and David Cameron demonstrated support for the NHS. Mark Simmonds, shadow minister of health, was passionate in his support for primary care when he spoke at our Conservative Medical Society fringe, where BMA chair Dr Hamish Meldrum, Professor Helen Lester, architect of QOF, and Professor Karol Sikora also spoke.

So what have the Conservatives got in store for the NHS and in particular GPs if they get elected?

There is no doubt that Andrew Lansley values and understands primary care.

He trusts the ability of GPs to commission services by giving them control of the budget rather than this being held at PCT level. This hopefully will allow innovation and get PBC going where it has stalled. The budgets will be kept separate from practice funds.

He also plans to scrap extended hours, allowing practices to decide what they need to provide for their patients, which is in stark contract to Labour who aim to make extended opening hours compulsory.

Andrew Lansley understands that many GPs think that out-of-hours provision has deteriorated. He will give back the responsibility for commissioning out of hours to GPs. This is not the same as actually providing the out of hours themselves.

On the subject of polyclinics, these will not be scrapped but a level playing field will be introduced so that they compete equally with other GMS providers.

In general, targets will be reduced and those that are set will be aimed on outcome rather than process. QOF is much more likely to consist of the results of chronic disease management programs rather than the keeping of disease registers.

There will be a far greater emphasis on public health measures such as lifestyle changes and screening. To strengthen this a Minister of Public Health will be created.

To reduce day-to-day political interference in the NHS, an independent board will be created which will allocate funds fairly to ensure equality of access.

Patients will be given more say in what they want by being provided with access to more transparent information on services.

Choose and Book was described as lamentable and as a demand management system which has failed to provide patients with the information they need to make decisions.

Understandably I think the ideas are generally good, although I do wonder how easy it is to achieve reliable information for patients - and whether patients are really that interested in choice. Equally clinical outcome can be difficult to measure. Quality care and cost rarely make good bedfellows and are not easy to measure when it comes to complex health issues.

I think GPs on the whole will want to be involved in PBC if they can see that it is going to make a difference. Holding the budgets and allowing savings to be used locally is attractive despite the work involved. I believe we could at last see a real shift to primary care in funding as a result. Certainly some of the savings could be used to fund the work of PBC groups.

As for out-of-hours, there are few GPs who want to go back to doing out-of-hours work but many who think it should be integrated with in-hours work. Commissioning the service should provide the opportunity to improve quality and integrate services better.

Dr Paul Charlson, chair of the Conservative Medical Society Dr Paul Charlson, chair of the Conservative Medical Society Interview with Dr Paul Charlson

Pulse caught up with Dr Charlson at the Conservative party conference - you can watch the full video interview here .

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