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Lansley to hand GPs management cash from April – but responsibility for debts will follow

By Gareth Iacobucci

Exclusive: GPs will be able to start recruiting commissioning staff within months after health secretary Andrew Lansley revealed he would hand them their first tranche of management allowance as early as next April.

Mr Lansley told Pulse the Government would award GP consortia ‘a subset, but not the majority’ of their management allowance in 2011/12, with the ‘great majority of resources’ made available in 2012/13, when GPs will carry out a dry run of commissioning.

Giving his first interview since last month’s comprehensive spending review, Mr Lansley set out how managerial resources would be passed to GPs even before PCTs and SHAs have been abolished.

But he also made clear the Government would not write off debts racked up by PCTs in their remaining two and a half years, and urged GPs to work closely with trusts during the transition period to ensure they don’t start off with huge financial millstones around their necks.

He said: ‘We’ve got an important transition period, which is not just about transfer of functions, legal responsibility and personnel. It’s also about making sure we achieve transition from, in some cases, deficits and instability to financial stability.’

Mr Lansley said the Government would be passing legislation to scrap many PCT functions altogether, some would be passed to the NHS Commissioning Board, and only those directly relevant to commissioning would go to GPs.

‘Soon we’ll illustrate to consortia and PCTs how we distribute functions. Some through legislation we will dispense with, some will transfer to the board, some to local authorities. We are creating not only a reduction in functions, but focusing consortia on commissioning of services for patients.’

In a further significant development, the health secretary used the interview to spell out his plans to create a competitive market across the NHS, with payment by results tariffs to be extended to the community by 2013. That will mean practices offering services within an agreed price framework, which he insisted would prevent GPs profiting excessively from their commissioning decisions.

Mr Lansley also admitted GPs would need robust systems to handle commissioning risks, hinting some particularly unpredictable areas could be taken off them: ‘That includes, if anything, more of the most costly and uncertain activities being managed by the NHS Commissioning Board itself.’

But it is his comments about PCT debts that have most worried GP leaders, with the health secretary insisting there would be no bail-out for troubled trusts, even though he admitted it would be damaging for GPs to inherit poor finances.

‘Asking GPs to start with legacy debts would mean they would be set up to fail,’ he said. ‘That does not mean in their own health economy they can just carry on and debts will be written off. It won’t work like that. The object is to arrive at a place in April 2013 where GP consortia are set up to succeed.’

But GPC chair Dr Laurence Buckman disputed Mr Lansley’s claim that PCT debts could be wiped out by 2013: ‘I’m sure GPs will be happy to help, but I don’t believe they’ll be able to wipe out the sort of debts PCTs currently have. I know he believes they will, but I don’t.’


Mr Lansley’s key disclosures

• GP consortia to receive ‘a subset but not the majority’ of their management allowance in 2011/12, with the ‘great majority of resources’ coming in 2012/13.
• GP practices will have to offer services within an agreed price framework, to prevent them from making excessive profit from their commissioning decisions.
• The Government will not write off PCT debts and is urging GPs to work closely with trusts during the transition period to ensure they don’t inherit huge deficits.
• The NHS Commissioning Board will test EU doctors’ language and competency as part of plans for it to take over management of GP performers lists.

Andrew Lansley Andrew Lansley on… management resources for GP consortia

More videos from the interview

Andrew Lansley on…

Responses to the Government’s consultation

Inheriting debts


Alternatively, the full interview is available here

Making your consortia a success

Hear advice on how to meet your responsibilities as a GP commissioner at the Essential Commissioning Skills seminar on 16 Feb and 3 March – More details here