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PBC 'the Achilles heel of reforms'

Practice-based commissioning is the 'Achilles heel' of current NHS reforms, a leading academic and former Department of Health adviser has claimed.

Practice-based commissioning is the 'Achilles heel' of current NHS reforms, a leading academic and former Department of Health adviser has claimed.

Professor Chris Ham, professor of health policy at the University of Birmingham, told a BMA conference that the failure of commissioning would threaten the 'sustainability' of the health service.

Professor Ham, a former head of the department's strategy unit, said the Government's target of 'universal coverage' by the end of the year was un-attainable.

He said: 'Commissioning remains the Achilles heel.

'Managing demand and activity through practice-based commissioning is going to be critical to the future health and sustainability of the NHS.'

Professor Ham said GPs needed more incentive to take part. Having to take responsibility for deficits had put many GPs in an 'awkward' position.

He said: 'GPs must provide an effective counter-balance but I see little hope of that happening beyond a minority of places.'

Dr Hamish Meldrum, GPC chair, said bringing in payment by results ahead of commissioning had caused chaos.

He said: 'There needs to be clarity, consistency and consensus about where we are going and an open debate about what sort of NHS people want.'

Jim Johnson, chair of the BMA council, said the NHS had two years to prove it had a future as a tax-funded system free at the point of delivery.

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