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Reaction to the health White Paper

Read the reaction from leading figures in general practice and the NHS to the publication of the Government's blueprint for the NHS.

Dr Chaand Nagpaul, GPC lead negotiator on commissioning

‘What we don't want is for the trust between patients and doctors to be interfered with by these sort of financial pressures. We support the role of GP's commissioning. GPs see patients on a daily basis and are a good antenna of the views of patients so we would like to be centrally placed in determining the sorts of quality and range of services

‘I think there will be a few individuals representing larger groups of GPs. We shouldn't be fearful that every GP is going to spend all their time on management - that's not going to be the case. GPs will need to be supported by strong expert managers- many of whom currently reside in PCTs'

Dr Clarissa Fabre, GPC member and GP in Uckfield

‘I'm concerned that we will run out of money, I'm very pleased that we will be having some power and patients will have some say about what goes on. I'm concerned, what happens when the money runs out?"

‘Another point I think was very good was bringing in social care, integrating health and social care'

Dr Michelle Drage, chief executive of Londonwide LMCs

‘My colleagues manage things every day… I haven't heard a word from Mr Lansley that I disagree with. Actually what happens at the moment is that management gets in the way of managing.

‘I think there is a Trojan horse risk of the private sector coming in and grabbing a market share that goes to its shareholders and doesn't stay within the NHS .'


John Appleby, chief economist, King's Fund

‘The evidence is rather mixed as to the ability of GP's to act like PCTs to be honest.. Their ability to do that is perhaps limited, after all GP's are clinical people, most of them became GP's to treat patients and not necessarily manage budgets and plan strategically for the health service."

Anna Dixon, director of policy, King's Fund

‘We definitely need innovation. We're facing a £20bn requirement to be more productive. But this is not a time for new providers, it's a period of contraction. We need fewer beds, we need fewer providers. So I can't see it being a very attractive market place for providers and we should realise that we already have in many cases a willing provider. We have a regulator that is blind to whether the providers are public sector, voluntary sector, private sector, and at the moment GPs should be able to refer patients to any of those providers, so some of these changes are not actually new. We shouldn't claim that this is a really radical privatisation. ‘


Karen Jennings, head of health, Unison

‘This is being forced on GPs, we understand that at least 50% of GP's don't want this. But let's cut to the chase - what Andrew has been very successful in doing is portraying this as moving money closer to patients but actually what this is about if marketisation and privatisation because if you look at all of the other policies that are going on this is about how are GPs going to manage money.'


Andrew Haldenby, director of Reform

‘On the point of privatisation one of the best things that this document does is say that the health system should be blind as to who provide the care and that must be right.'

Dr Hamish Meldrum, chair of BMA

'Doctors are ideally placed to help determine the health needs of their local population. Every time they see a patient they have to make decisions about their care, in partnership with them.

'Doctors, and their staff, already take the lead on designing services and innovating new treatments for patients and will be interested in discussing how these roles will be enhanced. They will wish to see how the proposed changes allow them to work collaboratively, and in partnership with their patients, to facilitate improvements in the care pathway and to see unnecessary barriers and bureaucracy removed.

'Any reorganisation of the NHS must take place in consultation with clinicians so that it does not cause any disruption to patient services or needlessly waste the valuable time of healthcare professionals.'

Dr Michael Dixon, chair of the NHS Alliance

'This is a unique opportunity for frontline GPs and the managers and other clinicians who work with them to make a real difference to the health of their patients, the services they receive and make the best out of limited resources.'

Dr Johnny Marshall, chair of the NAPC

'The coalition's plans provide general practice with a unique opportunity to raise the bar in the commissioning and delivery of care for its patients. The occasion will not present itself again.

'It is vital that primary care clinicians embrace the new world open heartedly to address the clinical and professional challenges ahead.'

Nigel Edwards, chief executive of the NHS Confederation

'Many people working in the NHS will welcome the principle of judging the performance of the NHS on health outcomes. But it is important to acknowledge that the clear targets set for the NHS over the last 10 years have delivered significant improvements to patient care.

'The transition of commissioning functions to GPs will require careful management over the next three years to ensure that the hand-over is smooth and patient care is not affected. It will also be essential to avoid a talent drain from PCTs- now is the time for strong leadership at a local level.'

The Secretary of State says that the value behind the White Paper will be 'no decision about me, without me'. We agree, but there is a long way to go to make parts of the NHS fit for purpose before the reforms will bring about the radical change needed by some patients in some parts of the postcode NHS.

Professor Chris Ham, chief executive of The King's Fund

‘Giving GPs responsibility for commissioning care and managing NHS budgets should result in services being more closely aligned with patients' needs. But, while some GPs will seize this opportunity, many others may be reluctant to come forward and lack the skills needed.

'Setting a deadline for GP consortia to take full financial responsibility for commissioning by 2013 is very ambitious - whether this can be achieved will depend on appropriate support being put in place.

Julia Manning, chief executive of 2020health- a health and technology think-tank

We have some concern over GPs being burdened with too much of all that commissioning entails: buying, selling, planning, strategy, monitoring, evaluating, performance management, specialism appraisals, data collection, reconfiguration, IT systems. However we see real opportunities for private contractors and social enterprises to become much more involved in providing and facilitating NHS services.

Cynthia Bower, chief executive Care Quality Commission

'Anything that gives people more say in how care services are monitored is a good thing. We already work closely with local groups and this will formalise and strengthen that collaboration. There is enormous potential here to share information and get local people even more involved in inspections and assessments.'

Dr Mike Dixon Your questions on the White Paper

Got a question about the health White Paper or GPs' new commissioning role?

Primary care tsar Dr David Colin-Thome has agreed to directly answer your questions and queries exclusively for Pulse. Let us know what you want to ask at feedback@pulsetoday.co.uk and we'll put your questions to him.

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