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Burnham: GPs have been 'sold a pup'

Shadow health secretary Andy Burnham has accused the Government of misleading GPs about their power to shape local services through CCGs, as he introduced radical new proposals to merge health and social care budgets.

Mr Burnham said that the Government had not delivered on its promise to put GPs in the driving seat of the NHS, citing the closure of Lewisham A&E as an example where CCG voices were not being heard.

Mr Burnham earlier spelled out plans to merge the health and social care budgets, which would see health and wellbeing boards taking control of NHS funds from CCGs.

In a briefing after his speech, Mr Burnham said he wanted to move away from clinicians leading commissioning completely.

He said: ‘I’m not planning on getting rid of CCGs… I remain committed to clinical involvement in commissioning. Clinical control of commissioning is a problem though because producer-led public commissioning isn’t necessarily a good thing.

‘Will those people take decisions that could inconvenience themselves, such as opening longer at evenings and weekends? That is something we will see more of as current reforms develop. It is better for the professions to be held to account by democratically accountable commissioning.’

Mr Burnham acknowledged that there will be a shift in responsibilities. He told Pulse: ‘[Former health secretary Andrew] Lansley should have just inherited our PCTs and SHAs and remodelled them. He didn’t need new legal entities… I am going to use the organisations I inherit and refocus them.

‘If that means the balance of power is going to shift, then so be it. But I don’t think it is clear where the balance of power lies in this new system. I think GPs have been sold a pup by the Government. They said it is all about you, you are in charge.

‘That is not how it is turning out. Already we are seeing GPs told what to do by the commissioning group. I don’t think the system is doing what it said on the tin. CCGs are being sat on from a great height. That is what I am hearing.’

But health secretary Jeremy Hunt said Labour planned a ‘massive restructuring’ of the NHS which would take power away from GPs.

He said: ‘I welcome the fact that Labour have finally recognised the importance of integrated care, but they had 13 years to achieve this and failed to do so. In fact, the system they left was fragmented and focused on treating patients as a collection of conditions not as individuals.

‘In the last two years we have put patients at the heart of the NHS by allowing GPs, who understand the sometimes complex conditions of their patients, to commission services to meet their personal needs.’

Readers' comments (8)

  • Yet more change. Great. Will there ever be a government brave enough to take a 10 or 20 year view?

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  • Not sure what Hunt is on about (last two years etc) they haven't actually started properly yet.

    We do need a joined up system of looking after people so its a good way to go. It would be nice to lose the market approach tools along the way but I'm not too hopeful.

    PCT Finance Manager

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  • One of Julian Tudor Hart's gifts to the NHS was the insight that planned and proactive care paid greater dividends that unlimited access. If Burnham is serious about a cost-effective NHS he'll not over-burden general practice with ever-longer opening hours. Most medicine is routine, and much of it complex, some medicine is urgent and much of it straightforward.

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  • Jonathan Tomlinson, this is a wonderful post. thank you for sharing it with us.
    - anonymous salaried!

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  • I also agree with Jon. Complex care needs careful planning implemented systematically. Much of the routine acute care in general practice needs no intervention at all. Trying to make patients consumers can never work, fundamentally because healthcare can be very complex, the patient does not hold the budget and the patient is often in a stressful or frightening situation needing help in deciding the best course of treatment. Just opening up capacity just creates more demand from the worried well who,would be best served by alternative actions such as self care, advice services etc.
    If Labour do get in, the prospect of another major reorganisation for the NHS could see clinical leadership
    and any enthusiasm for clinical commissioning rapidly wither on the vine with the NHS not far behind it.

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  • Andy Burnham is a pup

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  • This comment has been moderated

  • As far as I know CCGs have no powers to commission until the 1st of April 2013, so how could they have been commissioning for the last two years? What nonsense Hunt speaks.

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  • How ironic.
    Commissioning was introduced by the last parliament - Burnham was one of the Health Minister's - why didn't he stop it then?
    Fundholding / commissioning - put people off defer costs - once the deferrals reach the trough and unmet need stretches waiting lists / increases public dissatisfaction the projects are dropped again.

    My main issue with sustained ignorant attack is the risk that Primary Care will be irreversibly damaged (just like out of hours) especially as there were around 1000 trainee vacancies unfilled last year and within 2 years vast numbers of highly experienced GPs will have retired due to the pension and revalidation changes. Add in the loss due to doctors taking up salaried jobs and not giving as much unpaid work or partners working part-time to avoid punishing thresholds in pension / tax then primary care is in real danger.

    If anyone thinks that is no problem then do a little research upon the impact of lack of investment in primary care upon the cost of healthcare. We would have to get used to spending much more for no better healthcare (in fact probably much worse).

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