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A faulty production line

Labour to remove commissioning powers from GPs for vulnerable patients

Exclusive CCG leaders will lose the responsibility for planning the care of the most vulnerable patients if the Labour party wins the next general election, in a move that GP leaders have said will lead to further fragmentation of the health service.

Under plans signed off by the party’s policy-making body, health and wellbeing boards – run by local authorities – would be responsible for formulating plans for commissioning services for ‘people with long-term conditions, disability and frailty’, which CCGs will have a ‘duty’ to abide by.

But GP leaders warned that such plans would lead to further fragmentation of the health service, and would risk more services being removed from GPs.

The proposals are set to become Labour policy, and they represent a watered-down version of ideas originally mooted this year by shadow health secretary Andy Burnham to hand more commissioning powers to health and wellbeing boards, which are made up of representatives from CCGs and local authorities.

They were revealed in a summary of a policy forum held over the weekend, which exists to ‘shape’ Labour’s policies for approval at the annual party conference and an election manifesto that will be drawn up nearer to next year’s general election.

A post on the website of the Social Health Association, which has since been removed, said: ‘Health and Wellbeing Boards will have a central role in the commissioning process for people with long-term conditions, disability and frailty – people whose care is often most fragmented and who are heavy users of health and care services. The Health and Wellbeing Board would be responsible for creating a local collective commissioning plan for this group of people – within a nationally defined outcome framework for the development of whole-person care – with a duty of CCGs and Local Authorities to enact the collective commissioning plan.

‘In caring for those with complex needs, where local partners in communities want to move to a single budget for health and social care, or Joint Ventures, and have the capability to do so, the legislative framework should allow this to happen.’

The Labour party has confirmed to Pulse that this was agreed by its policy forum.

The policy forum also decided Labour has to break the trend of falling GP numbers by promoting general practice as a career choice and investing in primary care in deprived areas.

It also added its strong support for walk-in primary care centres, many of which have been closed down in recent years.

The summary said: ‘GP recruitment will be a priority for Labour, including through promoting general practice as a career choice, supporting GP returners back to work and encouraging recruitment in under-doctored areas.’

It added: ‘NHS walk-in centres have played a vital and successful role in enabling people to access care and relieving pressure on A&E.’

As previously announced, Labour wants to reintroduce a 48-hour GP appointment target, to be funded by money saved in commissioner budgets from not having to negotiate the competition rules that Labour intends to scrap.

According to the summary from the forum, this would see removal of the competition rules in the Health and Social Care Act and also Monitor stripped of its responsibility to ‘promote competition’ in the NHS.

But it is the new plans for CCG powers to be removed that has caused the most controversy, and GPC chair Dr Richard Vautrey said there were problems in handing health budgets to local authorities.

He said: ‘It is good that they have moved away from the idea of effectively making CCGs subcommittees of health and wellbeing boards – that would have been a mistake. But a key concern at the moment is fragmentation of services, and local authorities have an even greater tendency to tender out services to be provided by third parties. We would want reassurance that that would not be the case.’

But he said the focus on GP recruitment was to be welcomed.

‘The focus on GP recruitment is essential because the NHS depends on this being addressed. We need to see any future Government talk up general practice far more so that young doctors want to become GPs and do not feel like they will be in the firing line of hostile media and hostile Government.’

Dr Vautrey added: ‘While some walk-in centres can be helpful, actually you see far better outcomes by investing in existing GP practices, supporting them to expand their services to patients. This is better, again, than fragmenting services.’

Speaking to the policy forum, Labour leader Ed Miliband said: ‘David Cameron said the NHS was safe in his hands. He has betrayed the trust of the British people. And think what would happen to the NHS if he were to get back to power. It will be up to the next Labour Government, as it always is, to save our NHS from these Tories. Stop the Tory privatisation.’

Readers' comments (9)

  • Clearly, Ed Milliband doesn't trust those who commission services to be distancing themselves from the provision of those same services. How interesting.

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  • Its about bloody time all the members of parliament were all given some made up medical management titles then they could spend their time micromanaging primary care and would no longer by diverted by the annoyance of running the country .

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  • Vinci Ho

    This is obviously for the manifesto and it is unlikely to be any more details of the policies involved. To solve the problem of GP recruitment is easy said than done for them. HSCB is not to be scrapped altogether though section 75 will disappear if they win. I am sure that will still leave a big debate amongst medical professionals .
    Both Tories and Labour want to win this election as the outrightly but there is currently only several percentages in polls between them,though the real answer lies on those 'undecided' voters , as always .Of course , UKIP and Lib Dem would wish to be part of another Coalition Government .
    It will be interesting to know how many of our medical colleagues are actually 'undecided'.

    'The choice before human beings, is not, as a rule, between good and evil but between two evils.' G.O.

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  • They do know what CCG stands for right? I'll give them a clue - one of the word is COMMISSI_N (you may fill the blank).

    I can see another re-shuffle of the chairs starting with CCG getting dismantled and same executives/managers sitting on the same chair with different title!

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  • God save us from the meddling idiots who infest parliament - because the GPC won't!

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  • Whats that I hear another back of fag packet top down ill thought out reorganisation.This god forsaken mess we are in now has hardly hit the muck heap never mind settled in.God save us from politicians.

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  • Idiotic. Idiots!

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  • So the CCGs will be left with short term conditions in primary and secondary care as co-comissioning will be in place by then. Presumably most of tertiary comissioning comes into the category above. What a mess. Just as we are all trying to put commissioning back together, he is going to have a major restructure and break it apart again at a time of worsening financial crisis in the NHS. Everyone is telling him he is wrong including John Oldham. I never thought after the mess of restructuring done by the Tories I would be saying don't vote labour, they will make it worse.

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  • There is a way, and only one way, to minimise the incessant political destruction of medicine - go private.
    Let's be free from the rancid, fraudulent, two digit IQs that fester in Westminster.

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