The health secretary had a mountain to climb this weekend to convince GPs over his plans for commissioning - and he might have just scaled it.
The RCGP conference has never before had the pizzazz of an address from a secretary of state, but then these are extraordinary times.
Andrew Lansley needed to win over the profession after some major set-backs to his plans for GP commissioning and bravely decided to do this from within the lion's den (alternatively known as Harrogate International Centre).
He had a job to do. Consultation responses on his white paper proposals from the RCGP and the BMA have shown the level of concern over his plans amongst GPs.
Even the King's Fund – traditional supporters of greater leadership from doctors in the NHS - have argued against the abolition of PCTs and SHAs.
At a packed discussion session on the white paper the day before at the RCGP's conference, there were widely-expressed fears that the move towards GP commissioning would prove damaging.
The next chair of the RCGP Dr Clare Gerada expressed concerns over the move towards 'any willing provider' tendering processes and the removal of the national tariff.
'The revolution for me is the extension of market forces,' she said.
The strength of feeling in the room even led to outgoing RCGP chair Professor Steve Field warning GPs that there would be journalists in the room the next day and that they should make sure they represent the profession fairly.
By the time Andrew Lansley strode across the stage to the surreal and oddly appropriate soundtrack of Gorillaz's ‘Dare' there was an expectation that he had to perform well to win the hall over. And he did.
He admitted there were a ‘range of opinions' about his proposals, but explained it was all about releasing GPs from ‘state control' and getting better outcomes for patients.
He said that commissioning would enable GPs to pull in support for patients that were traditionally difficult to manage and would allow them to design services that were better for patients.
The payment system within the NHS would be redesigned to become a ‘powerful lever' for GPs to force hospitals to make their services better and enable GPs to be in the driving seat.
There was a lot of mention of ‘support' for GPs and that he ‘did not want to turn GPs into administrators'.
‘You will not be alone in this, the NHS Commissioning Board will support you,' he said.
It was an impressive performance. By the time he sat down, there was a noticeably different atmosphere in the hall. A sense of relief, perhaps even, hope?
But as one female GP said to me as we exited the hall: ‘I have enough to cope with just doing my job and getting on with my life. How am I going to find the time for all of this?'
Nigel Praities is deputy editor of PulseToday
Nigel Praities
