By Ian Quinn
Exclusive: GPs face being frozen out of leadership roles on the new NHS Commissioning Board, fuelling fears the body responsible for commissioning primary care and holding practice contracts will lack a real understanding of general practice.
Pulse understands health secretary Andrew Lansley has so far assigned several positions on the executive level of the NHS Board to a hospital consultant, senior managers, a nurse and a public health specialist, but is unlikely to set out a role for a leading GP.
Major GP organisations, including the RCGP and the BMA, are set to be represented on the board at a lower level alongside private companies – as Pulse has previously reported.
Sources close to the Government’s plans have suggested GP representation could be deliberately diluted because of concerns that active GPs will inevitably have conflicts of interest, either through their work with consortia or as providers.
But leading GPs said it was absolutely essential that a current member of the profession was on the executive board, since it would make key decisions about practice contracts.
Dr Helena McKeown, a GP in Salisbury and GPC member, said: ‘It seems very strange. I thought this was supposed to be about GP-led commissioning so it makes no sense not to have a GP on the board. It needs somebody with an insight into what GPs are facing to have credibility.’
Dr Johnny Marshall, chair of the National Association of Primary Care and a GP in Wendover, Bucks, said: ‘There would be value in having some GPs there given their role in the reforms, either in an executive or non-executive capacity.’
There is also some concern the NHS Board could be dominated by familiar faces, with Pulse understanding one position is likely to go to Sir Bruce Keogh, currently NHS medical director, with Sir Ian Kennedy, former chair of the Healthcare Commission, also slated for a role.
The public health role is set to be filled by new chief medical officer Dame Sally Davies, and there will also be a director of nursing role and another position for a leading NHS manager. Dame Barbara Hakin, a former GP, is believed to be a leading contender, but Mr Lansley is understood to be worried about accusations of conflict of interest if a current GP is picked.
Mr Lansley also plans to appoint a representative from a leading patient group.
A senior source told Pulse: ‘There will be some sort of GP representation, although we’re not sure at what level. The problem is it would be very difficult for any serving GP to be involved without them having to step in and out of the room at board meetings every five minutes because of the conflict issue.’
Dr Helena McKeown How NHS Commissioning Board could look
• Sir David Nicholson, currently NHS chief executive
• Dame Barbara Hakin, current national managing director of commissioning development
• Dame Sally Davies, chief medical officer
• Sir Bruce Keogh, NHS medical director
• Sir Ian Kennedy, specialist lawyer in ethics and health
• Director of nursing
• Patient representative
• Representation from RCGP, BMA, NHS Alliance, NAPC, Family Doctor Association and private companies