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GPs mustn’t get too loved up on Lansley

By Richard Hoey

The new health secretary may have got off to a dream start with the profession, but the GPC chair is right to warn of tougher times ahead, says Pulse editor By Richard Hoey

It comes to something when a health secretary is enjoying such a honeymoon that the GPC has to warn the profession not to get too loved up.

But that's exactly what GPC chair Dr Laurence Buckman chose to do in his keynote speech this morning, telling LMC representatives that Andrew Lansley would not turn out to be a softy.

He is right, of course, although it has been a fairly exhilarating few weeks, and perhaps GPs should enjoy it while they can.

Yesterday's announcements that the patient survey was too focused on access and could be scrapped, and that hospitals would be held to account for dumping work on GPs, could have come straight from the playbook of mainstream general practice.

Then there's the halting of plans for polyclinics and that mass shift of work to the community, the shelving of the revalidation rollout and the promise to put GPs in charge of the development of local health services.

Starting to swoon? Well, perhaps take Dr Buckman's advice, and get ready for tougher times ahead. Or rather, prepare yourself for the classic carrot and stick.

It seems likely that Mr Lansley is making a concerted attempt to gain the goodwill of GPs, in order to get the answers he wants when he presents some pretty searching questions on his commissioning plans to the profession.

GPs who can claim to have his ear suggest Andrew Lansley will be very happy to provide generous carrots for those practices that respond positively on commissioning – but they really will be expected to take on a huge amount of responsibility from PCTs.

And if GPs balk at calls to take on 95% of PCTs' commissioning functions, and refuse, they will feel the stick – and it could be fiercer than anything they got from the previous government, including the threat of funding cuts or even closure.

The Health Service Journal reports a DH source as bluntly summing up the impact of the changes on NHS management. ‘PCTs are screwed,' the source says.

GPs, for the time being, are still in love. But they could be screwed too, if the answer they give on commissioning is not the one that Mr Lansley wants.

By Richard Hoey, Pulse editor