The RCGP said that the Labour Party’s plans to place GPs under the control of hospital-led ‘integrated care organisations’ announced in a speech by Andy Burnham today could ‘destroy everything that is great’ about general practice.
RCGP chair Dr Maureen Baker said the college had ‘grave concerns’ about the plans, which she said contradicted Labour’s vow not to lead another top-down reorganisation of the NHS.
Her concerns were echoed by other GP leaders, including GPC deputy chair Dr Richard Vautrey and NHS Alliance chair Dr Michael Dixon, who said that the plans extend the idea that hospitals ‘queen it over primary care’.
Mr Burnham said he wanted every hospital to become an ‘integrated care organisation’ with ‘GPs at the centre’, and that hospitals should grow into the community and ‘into people’s homes’, providing an ‘end-to-end journey’ for patients.
But Dr Baker criticised the plans. She said: ‘The college has grave concerns about Andy Burnham’s proposals to create hospital-led integrated care organisations.
‘His plans could destroy everything that is great and that our patients value about general practice, and could lead to the demise of family doctoring as we know it.
‘Only yesterday he criticised the expensive and time-consuming top-down reorganisation of the NHS as a result of the Health and Social Care Act. Yet his proposals would be just as disruptive, causing even more upheaval for patients and distracting doctors and managers away from what really matters – delivering excellent patient care.’
The concerns were echoed by Dr Dixon, who told Pulse: ‘I think having it hospital led slightly defeats the purpose doesn’t it, of trying to invest your resources, time and effort in developing primary care, because what do hospitals know about primary care anyway?
‘So I think that’s the wrong starting point, it may be the right ending point though – provided there’s an equal say, and equal leadership between primary and secondary care.
‘But the models we’ve had so far tend to talk about hospitals queening it over primary care.’
He said: ‘GPs will be extremely worried about the creation of large organisations employing salaried GPs as this would lead to the destruction of practices which patients value so highly to achieve.’
But former RCGP chair Professor Clare Gerada said though she supported plans for an integrated care organisation leading on population health, this should be GP and nurse led.
She told Pulse: ‘What Andy seems to have said, which is absolutely right, is that we need organisations that look after populations, non-competing, geographically aligned organisations with ideally pooled budgets and planning done at that population level with GPs at the centre.
‘I think actually it should be GPs and nurses at the centre. So yeah, I think that is great.’
The shadow health secretary has said that GPs should shift towards being predominately salaried, comments which have led the GPC to call on Labour to ‘be honest’ on the fact that their proposals for the NHS amount to another major reorganisation.
The comments come as the RCGP released a 10-point manifesto, urging all political parties to adopt greater GP-led care integration and reject further reorganisations.