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GPs must ‘downsize’ or close hospitals, says DH commissioning chief

By Gareth Iacobucci

GPs must be prepared to close ‘rubbish’ hospital services as soon as possible if they are to successfully drive forward the Government’s commissioning agenda, according to Department of Health and GP leaders.

Speaking at the London Health 2010 conference in North London, DH commissioning chief Dr James Kingsland said the reconfiguration of healthcare would inevitably lead to some hospital closures, and said it was crucial that GPs engaged in dialogue with secondary care doctors as soon as possible over the potential changes.

His views were echoed by Londonwide LMCs chief executive Dr Michelle Drage, who said GPs would have to get tougher on de-commissioning ‘rubbish’ NHS services.

Dr Kingsland, speaking in his role as the DH’s national clinical commissioning lead, said the dialogue between GPs and hospitals over service reconfiguration would be one of the key challenges for GP commissioners to overcome.

He said: ‘We’ve probably had a widening of the divide. [but] clinicians from primary and secondary care all come from the same stock.

‘We have got to develop forums and recognise that this programme will be downsizing a sector. It will require, over time, certain parts of our hospital services to close, it will be moving large waves of work, particularly things like management of long-term conditions, from outpatients to within primary care.’

Dr Kingsland said the transition would require ‘a balance between the disinvestment in the low-tech possibly unnecessary activity in hospital but a reinvestment in the higher-tech requirements that we need from our hospital service’.

He warned: ‘GP commissioning will not work unless we have an early dialogue with our secondary care colleagues.’

Dr Drage added: ‘We put up with so much dross in the NHS, we don’t stand up and say when it is bad, unsafe, and inappropriate, and the time has come for us to stop doing that. GPs need to be encouraged to “out” the rubbish that is going on sometimes.’

GPs must ‘downsize’ or close hospitals, says DH commissioning chief