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Plan to scrap SHAs threatens GP training

By Gareth Iacobucci

The new Government's plans to scrap SHAs by 2012 in an effort to slash NHS administration costs will have ‘major ramifications' for the future of GP training, and could see budgets cut, warns the GMC.

Details of the health bill announced in the Queen's Speech reveal a new independent NHS Commissioning Board will combine functions currently provided by the Department of Health and SHAs, which will become regional offices.

The shake-up will lead to a clearer split between SHAs' commissioner and provider responsibilities – and is expected to see them relinquish control of GP education and training.

Niall Dickson, chief executive of the GMC, which recently merged with the Postgraduate Medical Education and Training Board to take responsibility for regulation of GP training, said the move could lead to a significant upheaval.

In his recent report to the board, which met shortly before the plans were confirmed, Mr Dickson said: ‘As SHAs currently hold the budget for postgraduate medical education, their disappearance or restructuring would have major ramifications.'

‘Whatever happens we know budgets will be tighter, that pay almost certainly will be frozen when current payments expire, and that education and training are likely to be particularly hard hit.'

The RCGP said it shared the GMC's concerns over funding for GP training, although it welcomed the reorganisation in principle.

Professor Steve Field, the college's chair, said: ‘We are optimistic that removing the educational provision from SHAs will be a good thing, as long as GP education is not squeezed, the opportunity to extend GP education is taken, and placements trainees need, in, for example, paediatrics are delivered.'

‘A shrinking of SHAs into regional offices could be a good thing as long as resources are maintained and used appropriately. Sufficient money has to follow the split to maintain the GP education network.'

Professor Field admitted it would be difficult to avoid a funding squeeze in medical education, but said that, given the shift of complex work into the community, it was crucial GP training was protected.

‘Undoubtedly resources will be squeezed in education. But more resources need to be move into primary care education from specialist. We are producing too many specialists.'

Niall Dickson: 'Whatever happens we know budgets will be tighter' Niall Dickson: 'Whatever happens we know budgets will be tighter'