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Shift of work to GPs ‘to last a decade’

By Gareth Iacobucci

The push of hospital services into primary care will continue for at least the next decade, health secretary Andy Burnham has emphasised in an exclusive interview with Pulse.

He said the huge financial challenges ahead could only be met if more services were taken into GP settings in the coming years, which he said would come to be defined as ‘the decade of primary care'.

It follows controversy over plans to implement a massive shift of hospital workload to primary care polysystems, which prompted GP leaders to join nearly 200 health service workers at BMA headquarters last week to rally against NHS cuts.

But Mr Burnham insisted:‘There is far more that can be done in the patient's home and in general practice to cut unnecessary referrals to hospital. If we're going into this coming period with no change to hospital services, that would take money out of primary care. My vision is the opposite.'

He also claimed the Conservative pledge to implement a suspension on hospital reconfiguration was not credible, saying: ‘A moratorium on hospital reconfiguration is not a sustainable position, and I think most GPs would probably acknowledge that.'

He admitted that relations had soured between GPs and the Government in recent times, but insisted he was ‘incredibly passionate about general practice.'

He said: ‘I know we're often portrayed as having a downer on GPs, but nothing could be further from the truth. If I look at my own constituency, there are lots of entrepreneurial, dynamic GPs and they are making real changes to the quality of care. That's what I want to see all over the country.'

Mr Burnham claimed the shift of work was a huge opportunity for GPs and that they would be offered the chance to run the services, rather than handing them to private firms.

Indeed, he quashed any suggestion that he might be attempting to backtrack after controversially calling for the NHS to be the 'preferred provider' - with private firms only turned to as a last resort.

'NHS services should get the chance to change before you ever go out to an open-market tender,' he said. 'I would defend that position to the hilt.'

But Mr Burnham's reoslutely upbeat tone wavered a little when discussing the potential impact of efficiency savings on frontline services. He seemed to withdraw the offer from health minister Mike O'Brien to name and shame trusts that opted for 'slash and burn' hacks at budgets, acknowledging that even cutting valued mental health services might be necessary.

NHS West Kent recently formulated plans to provide mental health services 'at lower cost' - with the trust admitting services were 'likely to be reduced in some areas'.

But Mr Burnham refused to condemn those plans, saying in essence that mental health services were fair game.

'The system is going to have to be under pressure for efficiency, there's not getting away from that. PCTs will have to create headroom.'

‘I would expect commissioners to take a hard look at mental health, so there may be parts of the country where commissioners can quite rightly say, ‘we are not satisfied we are getting the best possible value for money' compared to other parts of the country.'

Health secretary Andy Burnham The full interview

To read Pulse's full interview with Andy Burnham - including why he's scrapping practice boundaries and whether GPs can expect a pay rise - please click here.