Exclusive: The deepening controversy over the Government's NHS reforms is driving a wedge between GP commissioning leaders, with some calling for the health bill to be abandoned and one leading adviser admitting it could ‘fail' even at this late stage.
Health secretary Andrew Lansley has endured a tumultuous week, with the RCGP formally calling for the bill to be withdrawn and support beginning to splinter even among leading champions of commissioning.
RCGP chair Dr Clare Gerada became the first leader of a medical college to call for the bill to be scrapped. She had been granted a deferred mandate from the college's council to opt for outright opposition to the bill should she judge the amendments to it to be insufficient.
Dr Gerada said the bill would cause ‘irreparable damage' to the NHS, and added: ‘[We have] been left with no alternative.'
The NHS Alliance, an enthusiastic supporter of clinical commissioning, is split on whether the bill should be withdrawn. Its chair Dr Michael Dixon insisted the legislation must be passed to give sovereignty to GP commissioners and said amendments tabled last week – which included making it clear the health secretary and CCGs would be responsible for maintaining a ‘comprehensive national health service' – eased many concerns.
But other senior figures at the NHS Alliance disagreed, including Dr David Jenner, Dr Dixon's practice colleague in Cullompton, Devon, and lead for Eastern Devon clinical commissioning group. Dr Jenner signed a letter to the Telegraph along with 293 fellow GPs – including three other commissioning leads – calling for the bill to be withdrawn as it threatened to ‘fragment the NHS into a collection of competing private providers'.
Fellow NHS Alliance member Dr Brian Fisher also signed the letter, while Dr Ron Singer, a retired GP and founding member, wrote on Twitter: ‘Mike Dixon hopelessly clings to GPs winning out versus private-sector giants. Alliance split over this. It represents naïve GPs.'
Dr Isabel Hodkinson, co-vice chair of Tower Hamlets CCG, was one of those to sign the letter, and said: ‘Initially I was enthusiastic, but as I've seen how it's gone I've realised it's just not going to work. I'm really unhappy about moving commissioning support from the NHS.'
It came as Dr James Kingsland, a GP in Wallasey, Merseyside, and the national clinical lead for the NHS clinical commissioning community, admitted at a conference last week that ministers had ‘lost the narrative' on the NHS reforms.
Dr Kingsland, who is also president of the National Association of Primary Care, said the debate over the reforms had ‘stagnated', and there was now a risk the health bill would not become law: ‘We have lost the narrative of the reforms and there is a short time until the Queen's Speech – if we don't make it, the bill will fail. We have to just get the law in place – forget about whether it is right or wrong.'
Dr Charles Alessi, NAPC chair, said: ‘It would be a great pity if the bill doesn't go through because clearly anything that helps clinical commissioning is something we support.'
But a fellow GP close to Mr Lansley, who wished to remain anonymous, said the health secretary had failed to get his message across: ‘Once you alienate the professions, you alienate the public. The narrative, and some great opportunities for reform, have been lost.'