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Party lines drawn on PBC

The Conservatives have unveiled plans for all GPs to become commissioners – including the commissioning of out of hours – while Labour would allow commissioning to remain voluntary, it emerged this week.

The Conservatives have unveiled plans for all GPs to become commissioners – including the commissioning of out of hours – while Labour would allow commissioning to remain voluntary, it emerged this week.

In his speech to the NHS Alliance conference, shadow health secretary Andrew Lansley said:

‘At the moment, at best, GPs are seen as gatekeepers to the NHS – they open the door (for patients) and say "here you go, you're on your own now" and it shouldn't be like that.'

He added the practice should have responsibility for the whole process of care for their patients rather than a relationship built around a patient's immediate needs.

‘Commissioning should be in the hands of primary care practices.'

He added: ‘Commissioning needs to be not only consistent but to go far beyond what was intended in practice-based commissioning.

‘What I'm intending is a substantial transfer into the hands of primary care commissioners. It needs real budgets instead of notional budgets. It means you own the contract rather than the PCT owning it. It means you have the ability to vary the contract if you wish to.

‘It means when you make savings in your patient budget you have 100 per cent say on how those savings should be re-invested for the benefit of your patients and indeed not only for your patients but for the locality.'

Health minister Mike O'Brien told Practical Commissioning: ‘We know there are many practices that are capable of managing their own budgets. There are also some practices that are not.'

He added:‘We want to encourage more practices to go down the (PBC) route on a voluntary basis and not as Andrew Lansley would do on an imposed basis.'

Mr Lansley said as well as commissioning for practices there would also be locality commissioning would take responsibility for emergency and urgent care.

‘I think in access there is a powerful case for the commissioners at the front line having a 24/7 urgent care service to back up general practice.'

He then described how GPs would pool the services of walk-in centres, NHS Direct and the Out of Hours to create one urgent care service with one single number.

Asked if this meant existing out of hours services would be replaced, he replied: ‘That's up to GPs as commissioners to decide.'

Shadow health secretary Andrew Lansley Shadow health secretary Andrew Lansley

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