This site is intended for health professionals only

Letter of the week: Brace yourselves for commissioning chaos

If it is true that most GPs support the ending of PCTs then I suspect most of my colleagues have not thought about the vast work and responsibilities of PCTs.

I too thought commissioning sounded a good idea just as I had felt that fundholding benefited patients and the NHS as a whole.

But few GPs are aware of the complexities of modern commissioning, with its 200-page contracts and statutory requirements on monitoring and enforcing compliance. Maybe GPs believe handling this will be a price worth paying to lead the NHS.

In my experience, however, PCT staff are experienced, hard-working and motivated. Who now will manage contracting with primary care? We can’t contract with ourselves. Who will do the statutory public consultation and work with local authorities? Who will organise IT and informatics? No private company will want to sort all our problems without a high price. Who will manage accounts and budgets each quarter and audit accounts by July each year?

This is not fundholding – there will be no PCTs. I foresee chaos, a disaster of overspends, staff disputes and office problems and in the end replacement of PCTs by lots of smaller ones just when they were doing an excellent job. Why on earth didn’t the new Government just order PCTs to reduce their costs and let everyone concentrate on improving the NHS?

Politics is an odd business where the egos and arrogance of a few can override all that has gone before.

But the NHS is too important to be a political football and the BMA is wrong to support the white paper.

Submitted in response to: GPC publishes blueprint for GP consortia

From Dr Mark Preston, Newcastle upon Tyne

Letter of the week: Brace yourselves for commissioning chaos More letters

Click here for more letters from our readers.

If you wish to submit a letter to us then please email it to