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'Unintelligible' health bill is chance to empower GPs, says new NHS Board Chief

By Andrew McNicoll | 19 Oct 2011

GPs will need to use their commissioning powers to 'sort out' NHS care rather than complaining to ministers about the health service's failings, according to the new chair of the NHS Commissioning Board.

Addressing the House of Commons Health Committee, Professor Malcolm Grant, provost of University College London, said GP commissioners must stop pushing accountability up the chain to Westminster and instead use their commissioning powers to tackle difficult problems with hospital care.

Professor Grant was revealed as the Government's preferred candidate to lead the NHS Commissioning Board last week. He admitted the health bill was 'unintelligible', but that it offered a chance for the NHS to have stability away from political meddling.

Professor Grant said: ‘GPs have been empowered to make these decisions. If they are dissatisfied about what is going on in a hospital then they have to deal with it, not complain to a secretary of state that no longer holds the responsibility or to the NHS Commissioning Board which has given them responsibility. And if it is not sorted, GPs have to use their commissioning powers to ensure it is.'

‘We need to get away from running the NHS on the basis of shock to shock, crisis to crisis. We cannot do that by continually passing blame and accountability up the system.'

Following Professor Grant's address, Labour MPs on the committee tried to block his appointment, saying he had a ‘lack of experience of NHS structures and processes'. But the committee narrowly endorsed his candidacy for the NHS Commissioning Board post after a casting vote from chair Stephen Dorrell.

Following his appearence in front of the committee, the Department of Health has confirmed Professor Grant is expected to take up the post later this month. Health secretary Andrew Lansley said he would bring characteristics of 'leadership, independence and strategic direction to the Board'.

Speaking to the committee yesterday, Professor Grant said the NHS was 'one of the greatest institutions this country has'. Professor Grant, whose wife is a GP, said the fresh approach to commissioning was the only way of delivering the £20bn efficiency savings target set by NHS chief executive Sir David Nicholson.

'I have to say that the bill is completely unintelligible...,' he said. '...What I would see as the prize to fight for is restoring the NHS with the stability it needs away from political priorities.'

Professor Grant said he backed clinician-led commissioning, but conceded that some CCGs will not be ready to take on full commissioning responsibilities by April 2013. He said financial governance and propriety need to be at the heart of CCGs but warned that the NHS Commissioning Board needed to give CCGs the space and autonomy to do things their way.

Professor Grant said: ‘My natural instinct is to empower and devolve responsibility and let people do what they're best able to do. You and I cannot run a GP practice from Whitehall or Westminster.'

‘As a consequence of the principles of the bill about a lack of bureaucracy and autonomy we need to let CCGs do things their way. However, we need to strike a fine balance between financial accountability and energising and stimulating them to allow them to perform to the highest levels.'

 

Story updated 13:39

READERS' COMMENTS

Anonymous, Manager,
19 Oct 2011
GPs would not have to pass blame up to the SoS if they truely had control of the system but they don't. This is a case of the government attempting to delegate responsibility rather than authority.
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Anonymous, PCT,
19 Oct 2011
Unintelligible - well he's right on that count. I'd love to know how an unintelligible approach was the 'only way' to deliver £20bn savings. Not sure why he says that he can't run a GP Practice from Whitehall - what has that got to do with the White Paper?

All in all a puzzling candidate for an important role.

PCT Finance Manager
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Vinci Ho, GP Partner,
19 Oct 2011
The health bill is a political reality whether we like it or not. Somebody is going to do the dirty jobs of CCGs and the national commissioning board . Question is really which side they are on?
You can be just a puppet of government or a person of character and integrity . That will be judged by evidences and time .
Admitting the bill being unintelligible may be a start if he really meant what he said ......
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Edoardo Cervoni, Private GP,
19 Oct 2011
Mr Grant is a Professor of Law. I am sure he really meant what he said, knowing that what he said can be anyway twisted and bent like laws...In fact, I don't think anyone knows exactly how the NHS will look and how GPs will work following the implementation of this health bill. Looking forward, let's say 10 years down the line, I bet a new Health Bill will be implemented as it will be found that the previous one was not good enough to control the healthcare system expenses and to deliver good services. I disputed elsewhere why this shall be the case.
However, I agree with you at this point.
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Anonymous, Sessional/Locum GP,
19 Oct 2011
It's nice to know that GPs are to be held responsible for the mess left by Labour while their hands remain firmly tied by PCTs. I thought the latter were supposed to be abolished but they have even more power than ever. There is ample room to make £20 bn savings from bureaucracy but it will not happen because clinicians have no power over the managers who create it.
Retired GP
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Anonymous, PCT,
20 Oct 2011
anon retired - you are right to say that there is plenty of room to save buckets of money but please don't blame managers. The policies that cost so much to run are conceived in Whitehall not in PCTs.

Cost reduction should be managed - instead the mandarins in Whitehall think that they can control cost by introducing changes to NHS econcomies like PBR, FTs, Choice, AQP......Add the completely hands free implementation of Agenda for Change pay rates five years ago and you can see why we are in a mess.

PCT Finance Manager
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