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Tories will ‘rip up’ plans to shift workload to GPs

By Ian Quinn

Exclusive: The Conservatives have told Pulse they would ‘rip up' plans by PCTs to shift huge volumes of outpatient and A&E care to GPs, claiming primary care is not equipped to cope.

The party has pledged that if it wins power it would instead launch consultations with GPs on a local level to decide which services could be commissioned closer to home. The move creates a massive divide between Labour and the Tories on how to solve the NHS financial crisis.

Last week health secretary Andy Burnham told Pulse the shift of services from hospitals to primary care would continue unabated for the next decade.

But the Conservatives said they would call a halt to the shift of services being drawn up by trusts, including the national rollout of GP polysystems, if they were elected to power.

Shadow health secretary Andrew Lansley told Pulse: ‘This is not desirable or necessary. The Government is doing it based on a flawed analysis of future finances rather than focusing on how we improve care.

‘We all agree it would be desirable to have more services in the community, but we don't believe the facilities exist.'

He claimed trusts' efficiency plans stemmed from a ‘bureaucratic dictat from Lord Darzi': ‘You need the structure in place to cope. We would rip up this process. We would launch a series of local consultations with GPs to decide which services could be commissioned in the community, rather than introducing top-down reforms.'

An investigation by Pulse recently revealed trusts across the country have drawn up plans to shift services en masse to the community, with NHS managers having until the end of this month to present plans to the Department of Health.

Of 44 able to provide details, 38 had drawn up plans to shift huge amounts of work from hospitals to primary care.

But the Tories said they would halt even the most advanced plans in London, where PCTs propose a huge shift in care to more than 100 polyclinics.

Last week, Pulse revealed even the DH admitted moves to shift up to 60% of A&E cases to primary care would have to be scaled back, after a report by the Primary Care Foundation claimed the policy was based on grossly exaggerated estimates.

Mr Lansley said that assumption, together with the claim that up to 55% of outpatient appointments could be transferred to GPs, was ‘literally heroic' and had no factual basis.

GPC negotiator Dr Chaand Nagpaul welcomed the Tory pledge: ‘GPs have always supported having more services in primary care if they are adequately resourced and planned with GP input. But there has been no engagement of GPs and plans have been rushed to a political timescale. They have not yet been introduced – it's not too late to stop them.'

But health minister Mike O'Brien accused the Tories of an ‘abdication of responsibility', claiming plans to let GPs decide how to solve the crisis were ‘ad hoc and without any process'.

What the two parties are saying

Mike O'Brien, health minister
'The key Darzi components can be summarised as localised services where possible, and centralised services where necessary. That is the process that the Conservative party is attacking.'

Andrew Lansley, shadow health secretary
'It is assumed patients denied access to hospital services will be accommodated elsewhere in the community at a lower cost. The assumptions are literally heroic.'

Andrew Lansley: Tories would launch series of consultations with GPs rather than enforcing top-down reforms Andrew Lansley: Tories would launch series of consultations with GPs rather than enforcing top-down reforms

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