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GPs’ commissioning role puts conflict of interest at heart of NHS, says Burnham

The role of GPs in CCGs ‘enshrines a colossal conflict of interest at the heart of the NHS’, the shadow health secretary has told Pulse.

Speaking at a mental health conference on Thursday, shadow health secretary Andy Burnham said this is why Labour would take away GPs’ commissioning remit, as a key step towards addressing what he sees as the most damaging market-driven aspects of the NHS reforms introduced through the Government’s Health and Social Care Act.

Mr Burnham has pledged to hand health budgets over to health and wellbeing boards, resulting in shared responsibility between local authorities and the NHS – part of Labour’s new vision to incorporate all aspects of health and social care into one budget and deliver care to the ‘whole person’.

He told Pulse the move would not prevent GPs from having a key role in shaping services locally, but would be necessary to prevent erosion of public confidence in the NHS and the profession itself.

He said: ‘I think GPs were sold a false prospectus  - they were not being given what they were promised.

‘But there’s a bigger problem – the Act enshrines a colossal conflict of interest at the heart of the NHS. GPs are providers and it’s a difficult – almost impossible – thing to be both.

‘It places GPs in an invidious position that undermines public confidence.’

Mr Burnham said CCGs could be ‘refocused’ to become an ‘implementation body’, so that clinicians could still redesign services but without blurring their roles as providers.

He said: ‘Now that we’ve got this vision, it will be about how clinicians go about rebuilding services in their area to make them integrated, home-based, “whole-person”, but it isn’t visibly funding one rather than another operation – because in the end that will undermine the profession.’

Burnham, who was speaking at a conference held by the University of Chester Centre for Psychological Therapies in Primary Care, said his broader plans involve a ‘radical rethink’ of the system to link up social care with the rest of the NHS and deliver ‘whole person’ care.

He anticipates this will mean GPs taking on a more proactive role in coordinating all aspects of their patients’ health and social care needs.

He said: ‘I’m thinking of a new vision of general practice for “whole-person” care, where if GPs were offering a social rather than a medical model of care, maybe they would be providing better solutions for people that would save a lot of money.’

‘If they were able to spend public money in a much broader range of ways and sometimes prescribe more social rather than medical interventions, wouldn’t that empower general practice? That’s where my thinking is going.’