By Ian Quinn
Health secretary Andrew Lansley has claimed GPs across England have fully endorsed his plans for GP-led commissioning and do not want to wait until the abolition of PCTs to take over responsibility.
Mr Lansley said he and his ministers had been met with ‘enthusiastic’ backing for the proposals to form GP consortia to take on the £80bn NHS commissioning budget, in a series of consultation meetings taking place all over the country.
However, Pulse has learnt from feedback at a raft of events at PCT and LMC level that Mr Lansley’s plans are continuing to spark huge debate and uncertainty, with major concerns among many GPs over the plans to make commissioning a contractual responsibility.
Mr Lansley told the House of Commons that a meeting with GPs in Hampshire last week illustrated just how popular his plans were.
He said: ‘People came from general practices across Hampshire, and they fully endorse the principle of this change and they just want to get on with it.’
‘They did not want to wait for the full transition, and they now wanted to go through some of the detailed questions.’
Dr Nigel Watson, chief executive of Wessex LMCs, who chaired the meeting, described Mr Lansley’s verdict as an ‘interesting interpretation’.
However, he did say that GPs in Hampshire were ‘up for the challenge’ and were already engaged with their PCT about how the handover of commissioning responsibility will work.
He said: ‘There are a number of key issues which need to be sorted out if it is to work and there are many areas of uncertainty about the White Paper.
‘In terms of GPs commissioning what we told Mr lansley, who sat and listend and engaged with us for over an hour, is that for it to work they don’t want to be micromanaged, we need freedom from tomes or regulatory documents and we need to sort out the issue with funding.’
But he said Mr Lansley told GPs at the meeting he could not answer crucial questions such as how much management funding GP consortia would get, with estimates of £6-£9 per head believed to be based on specualtion rather than firm proposals.
He also declined to comment on how the Government plans to write commisioning into GPs’ contracts-with the GPC pledging to fight it altogether- and what levers and incentives it would bring in.
During a ministerial visit by Earl Howe to a practice in Grantham, North Derbyshire GP, Dr Ben Milton, said GPs were excited about the opportunities but had major unanswered questions about budgets, organisational size and structure and what the risk of failure was.
He said: ‘We can’t engage people if they don’t truly understand both the carrot and the sticks that are going to be put in place here.’
An official consultation over the health White Paper plans ends on October 11, with a subsequent health bill due to set out in more detail how GP consortia will work.
A report by NHS Warrington said GPs at a series of feedback events had expressed a ‘range of concerns about the time, competencies, skills, knowledge and motivation required’ to meet Mr Lansley’s plans.
It added there were ‘concerns about the need to be appropriately explicit about “profit” versus “service development” motives’, adding that many GPs wanted ‘to be allowed to continue to be clinicians only.’
It said there were fears among GPs over how to manage tension between competition and co-operation between individual practices.
However, the report said there was ‘almost universal acceptance’ that the change was coming and that GPs would have to embrace it.
‘Some saw it as “long overdue”,’ the report added.
Meanwhile GPs at a meeting in Birmingham have called for a legal challenge to the white paper because of what they claimed was the threat to single-handed practices.
Dr Martin Jones, a GP at the meeting pushing for the move, said: ‘It was recognised that many single-handed or smaller practices are at risk of going under if the white paper goes ahead.’
However, he added that there was apparently ‘neither the will nor the funds for the BMA to take on such a challenge’.
Mr Lansley faced criticism from shadow health secretary Andy Burnham in the Commons yesterday, who claimed the proposals had also ‘brought morale in the NHS to rock bottom.’
Andrew Lansley: GPs ‘just want to get on with it’ Andrew Lansley: GPs ‘just want to get on with it’ More on GP commissioning at the NAPC Annual Conference
A top line-up of expert speakers – including Andrew Lansley, Sir David Nicholson and Mark Britnell – will be addressing the latest developments in GP commissioning at the NAPC Annual Conference in Birmingham in October.
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