Exclusive A staggering 95% of GPs appointed to the boards of new clinical commissioning groups (CCGs) have not faced a contested election, a Pulse investigation reveals, amid claims of a ‘jobs for the boys’ culture and widespread disengagement among grassroots general practice.
Our analysis of almost 1,000 GP board posts across 150 prospective CCGs has found most were officially open for election, but only 7% of these were contested, raising fears that many GP commissioners are operating without a proper mandate.
Figures obtained from PCTs under the Freedom of Information Act show just 53 out of 770 elected posts were contested, while a further 213 GP board members were appointed without even a nominal election.
CCGs with a clean sweep of uncontested elections to GP board positions are represented within every SHA in England, with groups in the North East, West Midlands, London and Yorkshire among those to elect more than 10 GP board positions uncontested.
The results suggest the profession’s engagement with the Government’s flagship reforms is considerably weaker than ministers have claimed, and will raise significant concerns about the level of grassroots interest in commissioning.
The GPC has issued guidance advising that CCGs must repeat elections when they take on statutory responsibility for commissioning, and has called for ‘periodic re-mandating’ every three years to ensure grassroots GPs have a say.
GPC negotiator Dr Peter Holden expressed alarm at the investigation’s findings, which he said showed a ‘pathetic’ level of engagement.
‘It proves that the people driving this are enthusiasts. My belief is competition is healthy for democracy. If these people have just walked in there they may not have the confidence of the profession that such a victory might imply,’ he said.
‘My concern is the average GP has not realised the power of these CCGs. If we’ve elected people into positions of absolute power and authority without any means of calling them to account, we’ve just signed our own death warrant.’
GPC chair Dr Laurence Buckman said: ‘If it’s only the same old faces, then it’s up to someone to stand against them. But if people are being excluded then that’s a different matter.’
A GP in Cheshire who asked not to be named told Pulse the lack of contested elections in her area showed that the process was biased against salaried GPs and locums, and warned against a culture within CCGs of ‘jobs for the boys’.
She said: ‘There are definitely the same faces in charge, specifically men. The elections were not inclusive to salaried GPs and locums or to female GPs who have got a family and commitments.’
Dr Una Duffy, a GP in Luton, Bedfordshire, said: ‘Our CCG looks like exactly the same people doing commissioning as we have had before. There is a widespread apathy to commissioning. Ordinary, working, heads-down, seeing-patients-every-day GPs are quite happy to let the current commissioning enthusiasts get on with it.’
But Dr Charles Alessi, a GP in Kingston-upon-Thames who last week was elected to be the next chair of the National Association of Primary Care, said: ‘This might be explained by a lack of clarity over governance of CCGs. Whether more GPs come forward may depend on the bill and the degree of autonomy CCGs will have.’
The Department of Health said the number of pathfinders was proof of GP engagement: ‘It is codswallop to say there is a lack of GP interest.’