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RCGP commissioning champion resigns in protest at ‘covert rationing’

A senior GP leader has resigned from her role as an RCGP commissioning champion in protest against what she branded ‘covert rationing’ and ‘potentially dangerous practices’ taking place in the NHS.

Dr Helena McKeown, an RCGP council member, and a GP in Salisbury, said she had become ‘too disillusioned to be associated with the reality’ of commissioning to continue in the role, and said she wanted to instead ‘expose what GPs are being set up to do’.

Dr McKeown, who is also chair of the BMA committee on community care, told Pulse that the decision was not a protest against the RCGP, but against ‘the way clinical commissioning is going’.

She said: ‘I am feeling very disillusioned by the way clinical commissioning is going so I cannot remain a clinical commissioning champion. This is not about the RCGP or anything I have been asked to do in that role.

‘I am simply a GP-commissioner advocate who has become too disillusioned to be associated with the reality. If we were truly able to commission to make best use of resources and not tie ourselves to constitutions with open-ended commitments that interfere with our role as a GP, I would be proud to be asked to continue.

‘As it is, I can do more by resigning to expose what GPs are being set up to do: in the first instance to fail to keep within budgets devolved to a practice level, in the long-term to undermine our unique role as patient advocate.’

Dr McKeown added that she did not want to champion a commissioning policy that tied reductions in GP referrals to financial incentives, as she believed this could potentially put patients in danger.

Dr McKeown added: ‘Where  budgets are to be devolved to practice level I feel that reducing referrals in systematic ways such as by prospective referral management and effectively putting a third person into my consultation is too close to breaching good medical practice when there will be a financial incentive to do so. 

‘I am happy to discuss referrals and peer review and share learning, I am not happy to put my patients at risk, at the limits of my clinical competencies nor to be seen as a supporter of such schemes.’

RCGP chair Dr Clare Gerada lamented the decision, saying it was possible GPs can get involved in commissioning without supporting the Government’s NHS reforms.

Responding to Dr McKeown on the social networking site Twitter, Dr Gerada said: ‘You will be missed. RCGP supports improving GPs involvement in commissioning. This is very different from supporting the NHS Act.’

Dr Gerada added: ‘GPs are doing their best. They are doing what they think is right.’

The RCGP Centre for Commissioning was established in October 2010 to provide GPs and clinical commissioning groups with training and educational support, led by a number of specially selected ‘commissioning champions’.

But the college had to end contracts with dozens of the GP champions earlier this year due to funding constraints.

Dr McKeown is also one of 32 elected members on the RCGP council, currently chaired by Dr Gerada.

The RCGP was approached for comment, but was unable to submit a response in time for the publication of this article.


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