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Councils call for veto over GP commissioning decisions



By Ian Quinn

Local council leaders are urging the Government to let them take control of core elements of commissioning under the white paper, claiming GPs are not experienced enough to make key decisions over care for children, patients with long term conditions and the mentally ill.

In its response to the Government’s consultation, the Local Government Association claims large areas of patient care would be in danger of becoming ‘Cinderella services’ if GPs were allowed to make commissioning decisions.

Instead, it calls for councils, run by local politicians, to have the final say. The document also ‘strongly urges’ GPs to draw on the resources of local authorities for back-office functions, IT services and data collection.

The response backs the creation of so-called health and wellbeing boards to include council officers, politicians, patient groups and GP consortia leads, and calls for these to be given the right of veto over commissioning plans.

‘We also propose additional powers to sign off GP commissioning plans,’ it says, suggesting GP consortia should be ‘required to contribute to joint strategic needs assessments and to publish an annual joint commissioning plan’.

‘Local authorities should take a lead role in commissioning for services that in some areas are in danger of becoming Cinderella services,’ the response warns. It calls for locals council’s to take the lead where they have a ‘strong track record’, including mental health, homelessness, long-term conditions, drug and alcohol dependency, dementia and young people’s services.

Cllr David Rogers, chair of the Local Government Association’s community wellbeing board, said: ‘Councils need to be at the heart of commissioning especially in these Cinderella services. GPs are inexperienced here and there’s a real risk they may not see the incentive of commissioning services where success isn’t easy to measure. Councils know their residents’ needs best.’

The response puts the LGA on a collision course with the BMA, which in its response welcomed in principal an increase in local democracy but added: ‘We would be concerned if health issues became the subjects of local politicisation by local politicians.’

GPC deputy chair Dr Richard Vautrey said the LGA was wrong to question GPs’ ability to commission all services.

‘There no reason why GP-led commissioning can’t do it better than PCTs. The argument they would focus on certain groups doesn’t have any evidence behind it at all. What we don’t want to see is any additional bureaucracy making it impossible for consortia to do their job.’

Dr Richard Vautrey: Councils wrong to criticise GPs’ ability to commission Dr Richard Vautrey: Councils wrong to criticise GPs’ ability to commission