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Don’t panic! It’s the Hitchhiker’s Guide to GP commissioning



By Richard Hoey

A management allowance of £9 a patient? It could be the answer, says Pulse editor By Richard Hoey… but what exactly is the question?


Terrified, confused, befuddled over GP commissioning? Well, don’t panic, as Douglas Adams’s Hitchiker’s Guide to the Galaxy famously proclaimed on its cover. No one else appears to know anything either.

I’ve been spending the last week or so talking to a variety of leading figures in general practice, and it’s remarkable how little any of them know about how health secretary Andrew Lansley’s commissioning plans are going to turn out.

One leading figure at a top GP organisation admitted ‘we’re all just blokes in the pub’ when it came to discussions over GP commissioning. And that, he assured me, extended to Dr David Colin Thome, who just happens to be the Government’s primary care tsar.

The Hitchhiker’s Guide was notoriously full of dodgy information, and there’s been a fair bit of that flying around too. I’ve heard, from a number of highly placed sources, that everyone reckons the management allowance for GP consortiums will be £9 per patient.

I’ve heard from several other highly placed sources that the figure is nonsense, just one stage short of completely made up.

But what the figure really is, and here comes the reason for all the slightly contrived HitchHiker’s allusions, is the GP version of Douglas Adams’s answer to the meaning of life – the number 42.

It’s a figure, a potential answer, but it doesn’t give much away about what the question might be.

What is this supposed management allowance intended to cover?

Does it pay for the salaries of the managers currently employed by PCTs (minus the planned 45% cut in their costs, presumably)?

Or is it designed to pay for all the various things that PCTs do… not only the management, but the appraisals, the maternity cover, the HR, the training and all those other funny activities that will probably still need to be done by someone?

I really don’t know, but I’m not panicking, because neither does anyone else.

And while the pages of the guide to GP commissioning remain blank, it provides a golden opportunity for GPs to get writing.

By Richard Hoey is the editor of Pulse

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By Richard Hoey, Pulse editor