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PBC leader calls for clear definition of real budgets



By Susan McNulty

NAPC chair Dr Johnny Marshall has called for a clear definition of what a real budget means.

It comes as a recent survey showed 49% of GPs backed the option of access to real budgets. In the same survey, 34% of GPs did not want a real budget. Only 35% agreed they should have contractual responsibility for commissioning, with 44% against it.

The survey of 370 GPs, carried out last month by Practical Commissioning’s sister paper Pulse, comes as practice-based commissioners were waiting to hear the implications of the new coalition Government. Prior to the election, the Conservatives revealed GPs would be expected to operate in commissioning clusters of between 100,000 and 150,000 patients, with real budgets guaranteed.

National Association of Primary Care chair Dr Johnny Marshall said lack of a ‘clear definition’ of what a real budget meant in terms of risk and reward and what was actually being devolved could be behind GPs’ reluctance.

‘Until someone can put a real budget definition down in black and white, it’s difficult to know what you’re signing up to.’

Commenting on the 34% opposing real budgets, Dr Marshall said it was also important to have ‘local solutions that meet different situations. You can’t force people to take a real budget.’

It is believed a new GP contract, necessary to achieve any commissioning obligations, most notably out-of-hours, would take two years to introduce. Meetings regarding a contract rewrite were taking place between the Conservatives and BMA before the election took place.

Right-of-centre think-tank Civitas warned that GPs taking control of commissioning could be expensive.

James Gubb, director of the Civitas health unit, said it would lead to ‘relatively high management costs, no effects on the rate of innovation, introduce inequalities in patient care and decrease patient satisfaction.’

Possible benefits, he said, would be reduced waiting times, improved access to care and a wider range of services – but only where GPs were enthusiastic.

‘The fact is a lot of GPs don’t want to take this on.’

Civitas also criticised Conservative plans to open up the NHS market, citing the inability of private firms to access private NHS pensions.

NAPC chair Dr Johnny Marshall has called for a clear definition of what a real budget means.