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RCGP warns white paper timeframe could leave GPs at ‘breaking point’

By Ian Quinn

The RCGP has warned the scale and pace of change in the Government's health white paper risks leaving GPs at 'breaking point', while welcoming a greater leadership role for GPs.

The college has urged health secretary Andrew Lansley to think again about the timeframe for the changes, allowing GPs to learn from existing managers before PCTs are axed and with some members calling for PCTs to stay, albeit with more GP involvement.

If GPs are left to run NHS commissioning without adequate support, it says, the result would be a ‘disaster' for patient care.

The RCGP's response also claims that newly qualified GPs are generally more enthusiastic about the Government plans than those longer in the tooth, who fear it may have damaging repercussions for the doctor–patient relationship.

The RCGP's response, which comes days after the BMA raised a series of major concerns about the paper, echoes many of the areas of doubt, although the college is more effusive about the leadership potential for GPs.

‘Our members are enthusiastic about the opportunity for GPs to play a leading role in shaping services for their patients, ‘ says the response

‘Many of our members,' it adds, 'particularly those fresh from training or in the first few years of practice, are keen to participate in the commissioning of services. ‘They see inefficiencies that currently exist and already have ideas about how to address them.'

However, it says: ‘Others, already working exceptionally hard for their patients, are less keen to engage in commissioning, and seek reassurance that the core of our very successful system of general practice, the face-to-face consultation with patients, will not be damaged by the withdrawal of talented GPs into management and commissioning.'

The RCGP also warns that its members are concerned about a loss of ‘institutional memory' to the NHS in the loss of PCTs, a key fear also raised by the BMA.

‘Many of our members are concerned at the potential loss of management and commissioning experience from existing PCTs and other NHS bodies involved in this radical and rapid shift to GP commissioning.

‘Some members question the need for such a wholesale change in NHS structures, and propose instead considering less radical alternatives to achieve improvements in commissioning, for example by placing a much greater number of GPs on the boards of current PCTs.'

Calling for ‘greater flexibility ‘in the timescale of the changes, the RCGP warned that ‘PCT expertise is already being lost', with ‘many of the best managers and administrative staff are already seeking and obtaining alternative employment.'

GPs, it says, will require further training and education if they are to succeed in commissioning, expressing concerns at the ‘almost complete lack of reference to education and training requirements' in the white paper.

'There are concerns that the GP workforce will be stretched to breaking-point without adequate support, which would be disastrous for patient care,' it concludes.

RCGP chairman, Professor Steve Field, said: ‘Our members - "jobbing" GPs throughout the UK - can always be relied upon to act professionally and constructively, with the best interests of our patients at heart.

‘We feel that this response is as comprehensive as possible and that it appropriately reflects and represents the views of RCGP Members.'

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