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Gerada: Health bill should be amended again or withdrawn

Exclusive The RCGP will back the BMA's call for the health bill to be withdrawn unless ministers make a raft of further amendments to address GP concerns, the college's chair Dr Clare Gerada has told Pulse.

In an exclusive interview, Dr Gerada said GPs still harbour ‘very real concerns' over the bill despite the Government's high-profile revisions last month, and fear the legislation will pitch private companies against NHS providers and burden GPs with extra red tape.

A Department of Health spokesperson said the RCGP's stance – which follows the call from BMA chair Dr Hamish Meldrum last week for the health bill to be withdrawn – was ‘disappointing'.

Dr Gerada also said that local hospital consultants should be allowed to sit on the boards of clinical commissioning groups – despite the Government ruling this out due to concern over the potential for conflicts of interest.

Warning that many GPs are suffering from ‘bill fatigue', Dr Gerada told Pulse: ‘The coalition Government needs to listen very carefully to GPs who have absolutely no other concern apart from patient care. If the bill can be amended so that GP concerns are addressed then so be it, but if it can't, because it is such a complex bill, then we would need to look at ways to support the BMA's view [that the bill should be scrapped].'

‘Competition is still at the heart of the bill, we have anxieties over Any Willing Provider, and I'm still not clear on the issue of duty to provide. What I don't understand, as a GP, is why the Prime Minister won't do what he said he would do and that is restore the wording of the 2006 [NHS] Act.'

Last week Pulse revealed that an RCGP survey conducted after the Government's amendments to the health bill had found the changes had failed to win over the profession. The poll of more than 500 GPs found 85% were not ‘reassured' by the revisions, and half of GPs still oppose the ‘general direction' of the health bill.

Dr Gerada criticised the pace at which the revised bill is to progress through Parliament, and pointed out the RCGP was given just four working days to scrutinise and consult members on 148 pages detailing 63 key amendments before presenting evidence to MPs.

‘There has not been enough time for us to consult our members or for GPs to fully understand the new bill. It took months to understand what the previous bill was about and we need time to fully comprehend this one and what the revisions mean,' she said.

While admitting that there are some scenarios in which private providers can ‘add value' to patient care, Dr Gerada said the market-driven nature of the revised reforms had ramped up GP fears that companies will be ‘pitched against the NHS' to the detriment of care and ‘cherry pick' the most profitable patients.

But she welcomed the revised bill making the newly-rebadged clinical commissioning groups statutory bodies, on the grounds that it brings ‘transparency and accountability' to GP commissioning. She was also positive on the bill's mandatory requirement for hospital consultants to sit on commissioning boards - but took issue with the requirement that consultants cannot be local.

‘Despite the bill insisting otherwise, I have no issue whatsoever if it is a local consultant involved [on commissioning boards]. I actually think you need a consultant that does feel for the area, not someone from outside. The key is that consortia are large enough to eliminate conflicts of interest.'

Yesterday Shadow Health Secretary John Healey accused the Prime Minister of ‘a serious and reckless misjudgement' on the NHS reforms and warned the reforms would cost the NHS £850m on redundancies and up to £2bn in total.

Responding to Dr Gerada's comments Steve Field, chairman of the NHS Future Forum and Dr Gerada's predecessor as chair of the RCGP, said: 'It is extremely disappointing the RCGP have taken this view. As chairman of the NHS Future Forum, our independent report has been taken seriously [by the Government].' 

'In particular they responded to our criticisms of Monitor and significantly changed its remit as a regulator, and endorsed our view that competition has a place in the health service but not as an end in itself. It has also responded to our strong views about cherry picking and supported us in our requests to do more to reduce health inequalities."

A Department of Health spokesperson said: ‘The RCGP's position is disappointing because they previously said we must work together to meet the challenges the NHS faces in the future.The RCGP also said they were pleased we addressed the concerns they had about competition, choice and the role of the private sector. The fact is we will never privatise the NHS.'

‘The independent NHS Future Forum confirmed there is widespread support for the principles of our plans to modernise the NHS, including handing more control to doctors, nurses and frontline professionals. Our plans have been greatly strengthened in order to improve care for patients and safeguard the future of the NHS.'