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No safety blanket, but the health secretary is confident he can take GPs with him

The devil will be in the detail, but by the end of the year we should know what GPs really think of Mr Lansley's commissioning plans, writes Practical Commissioning editor Sue McNulty

Jacket off, speech 'filed' on the Department of Health website and speaking in front of the lectern, health secretary Andrew Lansley seemed relaxed as he addressed today's NAPC conference.

His comments that GPs will have to ration drew no reaction from the audience.

'Two and half years is long enough - two and a half months will be enough for other consortia,' he said.

Again, the audience listened on.

Mr Lansley acknowledged the spectrum of GPs' attitudes to the reform - but he also said that he heard from GPs many times that their ideas weren't listened to.

'It's a little like the book Life of Pi - you open the door and the animal doesn't come out' was how he put it.

He cited the BMA and RCGP as supporting the reforms, saying 'they just have questions and concerns'.

GPs are risk-averse. They like having their little business but it's not a real one. What other business has a guaranteed income or a ready made group of customers? GPs might say they want guidance or detail but I reckon many want a safety blanket.

I don't think they'll get one but Mr Lansley said they will know what PCT duties consortia will have to assume before the end of the year, pathfinders will be in place to show 'how it can be done' and the magic number for the management allowance will be known by December.

It's at that point I will be interested to know what GPs really think of the reforms.

From the mood at today's conference, if they get those details right, the GPs here are happy to stay along for the ride.

Sue McNulty is editor of Practical Commissioning

Practical Commissioning editor Sue McNulty Practical Commissioning editor Sue McNulty Click here for more live coverage from the NAPC conference NAPC conference