RCGP urges Government to delay compulsory GP commissioning

By Ian Quinn

The RCGP has urged Andrew Lansley to put back his plans for GP commissioning, after the biggest survey of GPs to date showed fierce opposition.

In a major blow to the health secretary, a college report said its consultation of members, which will result in a formal response to the Government, had unearthed ‘major concerns' and called for the time frame for the reforms to be extended.

It warned plans for GP consortia to replace PCTs risked destabilising the NHS, and could swamp practices with extra workload and take clinicians away from the front line, while opening the door to the private sector.

While the RCGP said the consultation had seen GPs recognise opportunities to increase their leadership role in the NHS and that it was sure ‘GPs will rise to the challenges', it called for a more considered approach.

There were, it said, widespread fears the moves to set up commissioning groups across the country would increase health inequalities.

The report said there had been ‘a significant number of comments on the risks of these reforms to the NHS in England.

‘GPs will be seen as the purse-holders: this could reduce public trust and decrease their ability to advocate for patients, and they will be blamed for failures and cuts in services,' it said.

Many GPs felt they lacked the time, skills and capacity for commissioning and felt ‘the reforms open a door to increased involvement of the for-profit private sector' and could even lead to the ‘break-up of the NHS'.

‘We believe GPs can assist in the efficient use of NHS resources, and wish to play an active role in reducing waste and duplicated effort,' it concludes. ‘However, some of our members are not convinced the scale of the changes proposed is justifiable, especially in the context of cost reductions.'

However a Department of Health spokesperson insisted GPs across the country were generally supportive of its proposals.

'In reality, the report reflects the feedback we've had from engagement events across the country - most GPs are enthusiastic about the opportunities offered by the white paper, but many are also apprehensive,' she said.

'For this reason, we will ensure that detailed implementation issues are tackled during the course of transition, and we look forward to the RCGP's full response to the White Paper consultations.'

At meetings across the country, Mr Lansley's plans have met with a similar mixture of enthusiasm and trepidation.

Dr Nigel Watson, chief executive of Wessex LMCs, said after a meeting with Mr Lansley that while GPs were up for the challenge there were ‘many areas of uncertainty'.

Dr Ben Milton, a GP in Matlock, Derbyshire, said: 'We can't engage people if they don't truly understand both the carrot and the sticks that are going to be put in place here.'

GPs at a Birmingham meeting called for a legal challenge to the white paper due to what they claimed was the threat to single-handed practices.

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