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Consortia must not hold GP contracts, GPC warns

By Ian Quinn

The GPC has issued supplementary evidence to the Government's white paper consultation, warning that handing responsibility over practice contracts to GP consortia would fuel potential conflict of interest.

It follows calls from both the National Association of Primary Care and the NHS Alliance for the Government to give consortia major new powers over individual practices.

The NAPC has called for consortia to be given power over all contracts, claiming that the NHS commissioning board would become overly bureaucratic and top-heavy if, as previously proposed, it holds the performance-managment duties.

It has called for consortia to have the right to terminate practices' contracts and have the right to pre-approve referrals.

However GPC chair Dr Laurence Buckman said the committee was urging the Government to resist the move for consortia to wield such power over their fellow GPs.

Speaking after a meeting of the GPC, he said: ‘The Government has previously said contracts should be held at national board level. We do not believe that consortia should hold primary care contracts.'

He added there was ‘a risk of conflict of interest and confused roles' which could make consortia undemocratic and expose them to potential scandal and conflict among practices.

Earlier this week Pulse revealed the issue of who leads consortia is set to be hugely complicated by potential conflict of interest issues, with as many as one GP in four having an investment in a local private provider of NHS services.

The indications from NHS leaders are that the Government will shy away from handing consortia contractual levers.

Dame Barbara Hakin, the national managing director of commissioning development at the DH, told the NAPC conference yesterday: ‘If we had a situation where primary medical care commissioned primary medical care, where's the probity, and the checks and balances?

‘[But] consortia will be able to ask the board to commission some things on their behalf.'

Earlier this week Dr David Colin-Thome, national clinical director for primary care, also appeared to rule out a contractual clampdown on GPs.

He told the Commons' Health Committee inquiry into GP commissioning that the Government was determined to move away from a top-down bureaucratic approach to general practice, and instead adopt a ‘softer' process of engaging GPs in decision making.

‘The first reaction [in the past] has always been to create a contractual relationship,' Dr Colin-Thome said. ‘It's this that has alienated so many clinicians. It becomes a bureaucratic exercise.'

The NHS Alliance has called for the NHS commissioning board to be able to delegate the power to hold GP providers to account, but said the board should retain the responsibility for contractual performance.

Dr Laurence Buckman: consortia's possible conflict of interests means they should not hold contracts Dr Laurence Buckman: consortia's possible conflict of interests means they should not hold contracts