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Councils could hold GP contract, says Alessi

Policy-makers should consider the idea of local authorities holding the GP contract, the chair of an influential group of GP commissioners has said.

Dr Charles Alessi, who is chair of the National Association for Primary Care, told an audience at the commissioning show in London today that the model was attractive and was a third way between the independent contractor status and being part of large groups of integrated providers.

Dr Alessi, who is one of the pioneers of the PMS contract, said that ‘people… are thinking about that now’ as a means to introduce more localism into general practice.

Responding to a question from the floor on the future of the independent contractor status, Dr Alessi explained: ‘I would suggest there’s also another variant we haven’t talked about, and that’s general practice and local government.

‘Because some people I know are thinking about that now. That is really quite attractive in the models you’re describing.’

Speaking to Pulse after the talk, Dr Alessi explained he personally wasn’t advocating the stance, but said: ‘What I am suggesting is, one has to keep a completely open mind about these things.

‘I’m not advocating that everybody immediately gets a contract with their local authority. If you’re thinking in terms of “local” being where things are happening, then clearly there is some benefit of people working with in that system.

‘It’s pretty obvious what the advantage could be.’

Dr Richard Vautrey, deputy chair of the GPC, said: ‘Local authorities would not and should not hold GP contracts. It would be a rapid route to large scale commercial companies taking over. Local authorities are rapidly moving away from holding contracts and instead commissioning private providers to deliver services once done by themselves.’

‘The obsession with the independent contractor status is misplaced. The problem is that we only have 3/4 of the necessary funding to make practices sustainable, not the fact that GPs hold the contract. Indeed the ICS is one of the main reasons why general practice is so cost effective and responsive to change.’