By Gareth Iacobucci
Exclusive: GPs raised the prospect of a two-speed NHS this week after the majority said they would not want their consortium to take on commissioning by April 2013 following the Government's formal relaxation of the deadline yesterday.
The Government said yesterday that only clinical commissioning groups that are 'ready and willing' will be authorised to take on full budgetary responsibility from April 2013.
But a Pulse survey of 200 GPs, conducted before the Government announcement, indicated only 38% wanted their consortium to press forward on the original timetable for commissioning. A further 18% of the GPs – surveyed by email and phone – said they wanted their consortium to take on commissioning at a later date, while 44% did not want to take on commissioning at all.
The findings suggest grassroots GPs will be plunged into conflict with their far more bullish consortium leaders, after a Pulse survey of 20 consortium chairs last month found 19 were intent on meeting the April 2013 handover date. They also raise concerns over how the NHS will be run in many parts of England after April 2013, after the Government said
The Government yesterday said there will no reprieve for PCTs, and that the NHS Commissioning Board should take over in April 2013 where GPs were not ready. Some advanced commissioning groups may be authorised by the board earlier, however, with authorisations taking place from October 2012.
The change came after a report from the NHS Future Forum published on Monday, an advisory panel led by former RCGP chair Professor Steve Field, recommended the deadline was scrapped.
Professor Field said: ‘We don't think there should be an opt-out, but the April 2013 date may be too onerous for some. Some could move quicker.'
Dr Johnny Marshall, chair of the National Association of Primary Care, warned relaxation of the deadline could lead to a two-tier system if PCT clusters and the NHS Commissioning Board failed to support GPs in getting ready: ‘The concern we might create a two-tier system identifies the importance of ensuring clinical commissioning is as widely available as possible from the beginning.'
Dr David Shubhaker, secretary of Redbridge and Waltham Forest LMC, said: ‘This will make it even more confusing. The whole country should be doing the same – they should wait until everybody is ready.'
The BMA has broadly welcomed the Government's shift in position on the NHS reforms.
BMA chair Dr Hamish Meldrum said: ''It is reassuring that the Government recognises there are still a number of issues to work through. It is particularly important that dialogue continues on education and training and the development of incentives for commissioners. We look forward to continuing our discussions with the government to help ensure that NHS reform is best for patients and workable for staff.'
GPs in our survey were more sceptical, with 69% questioning whether it had been a genuine listening exercise. But there was a slight rise in support for the NHS reforms on our tracker question, with 31% of GPs now backing plans for GP commissioning and budget holding, up from 23% in January, although still much lower than the 51% in July last year.Majority of GPs do not want 2013 start for commissioning