By Ian Quinn
Exclusive: GPs in deficit-hit PCTs are faced with inheriting a combined debt that has already reached well over a quarter of a billion pounds as a growing financial crisis threatens to undermine the Government’s NHS reforms.
GPs in deficit-hit PCTs are faced with inheriting a combined debt that has already reached well over a quarter of a billion pounds as a growing financial crisis threatens to undermine the Government’s NHS reforms.
Pulse’s analysis of the financial projections of 148 trusts in England reveals just how serious GPs’ debt legacy is set to become, and follows health secretary Andrew Lansley’s admission consortia would be ‘set up to fail’ if they began in deficit.
An accompanying survey of GPs reveals the Department of Health’s refusal to bail out troubled trusts is set to undermine its attempts to involve GPs in commissioning, with three-quarters saying the prospect of debt would make them less likely to play an active role.
Pulse this week launches a new campaign, A Clean Slate, demanding GPs should take over commissioning responsibility on an equal footing, with zero debt, to prevent damaging health inequalities as some areas find themselves hampered from the start.
We will press ministers and NHS managers to reconsider the decision to insist consortia take on debts – arguing GPs will otherwise be forced to choose between endorsing unsustainable PCT cuts to patient care or accepting a huge handicap when they take on commissioning responsibility.
A quarter of PCTs are currently projecting deficits, averaging £9.4m each, with the combined £338m debt almost as large as the £362m surplus among those trusts that say they will meet their legal duty to at least break even. And many of these are warning their plans rely on huge cuts and ‘spending all contingency funds’.
Pulse’s A Clean Slate campaign will press politicians and NHS leaders to prevent debts being handed over, both through stringent financial management of PCTs and by bailing out those with uncontrollable debts with the surpluses from other trusts.
Dr Michael Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon, said he had already secured such an agreement in the South West: ‘The alliance’s stance is GPs shouldn’t inherit debt. I’ve had a personal verbal assurance from Sir Ian Carruthers, chief executive of NHS South West, that no debts will be handed on.
‘My understanding is this will have two components: one, battening down the hatches; and two, passing the surpluses around so deficits are cancelled out within the SHA.’
But GPs elsewhere have had no such assurances. Dr Adam Skinner, a GP in Westerham, Kent, is among more than 160 who have already pledged their support to Pulse’s campaign. He said: ‘I think it is disgraceful that we inherit the debts of the PCT. It is like changing the captain of the Titanic after hitting the iceberg.’
GPC negotiator Dr Peter Holden, who has also signed up to our campaign, said: ‘I’m very concerned when we start commissioning it’s going to be like swimming with our hands tied behind our back and several millstones around our neck.
‘It’s another landmine lying in wait for us, along with long-term contracts and PFI deals.’
Dr Adam Skinner: inheriting PCT debt is like changing the captain of the Titanic after it has hit the iceberg Dr Adam Skinner: inheriting PCT debt is like changing the captain of the Titanic after it has hit the iceberg Click here to read more about our campaign A clean slate Join us
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