GP pathfinder leaders have implored ministers to ensure clinical commissioning groups (CCGs) do not have their hands tied by excessive bureaucracy from the new NHS Commissioning Board.
Delegates from more than 100 commissioning groups who attended a joint NHS Alliance and National Association for Primary Care meeting in London this week told health secretary Andrew Lansley they feared that amendments to the health bill have handed too much power to the Board.
But both the health secretary and NHS chief executive Sir David Nicholson, who will head up the new board, insisted GPs would not be constrained under the new arrangements, and said a huge ‘culture change' would take place in the NHS.
NHS Alliance chair Dr Michael Dixon voiced the pathfinders' concerns to Mr Lansley over the prospect of ‘excessive bureaucracy'.
He said: ‘Our concerns are not ourselves - our real concern is that we want to emancipate ourselves but feel we might be stopped from outside sources.'
But Mr Lansley said the new structures were a ‘remarkable departure' from previous systems where ‘intermediate tiers of management' were in control.
And Sir David Nicholson said there would be no room for managers who refused to adapt to the new ways of working.
He said: ‘My responsibility is to support you to be the best you can be. That is a very different starting point from "it is my job to tell you what to do".'
‘We need to work with you in a way we haven't done before. Anyone who wants to work in this environment will have to get their head in a very different place.'