This site is intended for health professionals only

Removal of GP gatekeeper role would be a mistake, warns Dixon

GPs’ gatekeeper role in the NHS should be strengthened and not undermined, says NHS Alliance chair Dr Michael Dixon in response to ideas the Labour Party health policy review group is considering.

The warning comes after Pulse revealed last week that the Labour Party policy review group is to consider plans from union Unite where GPs’ gatekeeper role would be ditched in favour of direct access to specialists and a ‘multidisciplinary team’ leading on patients’ care.

But the NHS Alliance chair warned it was ‘very concerned’ about the plans. Dr Dixon said: ‘Numerous research (eg, from Barbara Starfield and WHO) has shown that a health service predicated on primary care delivers better mortality statistics, improved health, and is more cost effective.

‘This has traditionally been the strength of general practice and its siblings in primary care in the UK. We should be strengthening the role of GP as gatekeeper not threatening to demolish it.’

Commenting on Labour Party ideas for health and wellbeing boards to take control of budgets currently held by CCGs, Dr Dixon that CCGs should work ‘in tandem’ with the local health and wellbeing boards, but that clinicians should not have ther commissioning role undermined just six months into the new system.

He said: ‘For many years frontline clinicians have been frustrated by services that do not respond to their patients and the physical and social environments that seem too often to damage their health rather than aim to improve it. Only since 1 April 2013 have clinicians been offered the baton to lead on the planning of local services and health initiatives.

‘It is odd that Labour (having supported practice-based commissioning) should want to undermine the authority of clinical commissioners and CCGs after they have been in action for only six months - and to pit them against local councillors and local democracy.’

He added: ‘Surely the right way is for both to work together to avoid any further reorganisation and to allow clinical commissioners and health and wellbeing boards to forge their own future in an organic way, and unhampered by the dictates of politics and political pragmatism?’