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Ministers – and GP leaders – are getting jumpy over the white paper

By Richard Hoey

The Government is becoming increasingly edgy as GPs cast their verdict on its commissioning proposals, and isn't taking kindly to criticism, says Pulse editor By Richard Hoey


Being a messenger is a notoriously risky job.

We've been dodging the pot shots in Pulse towers this week, as we've reported on the first wave of responses to the Government's white paper – not all of which have been entirely positive.

Certainly, the RCGP report of its internal consultation on GP commissioning was surprisingly strongly worded, welcoming the chance to take leadership of the NHS, sure, but also expressing a series of ‘major concerns'.

One of those ‘major concerns' surrounded the pace of the planned changes, but if you might have thought that equated to a call for GP commissioning to be delayed, I have now been firmly disabused of that notion – not least by the Department of Health.

Thankfully, it was one of the more junior members of the office who took the full force of the DH's displeasure as it attempted to stamp on signs of rebellion from GPs… its nervousness no doubt fuelled by the decision of shadow health secretary Andy Burnham to tweet our story.

The more nuanced version of what the RCGP is saying is that commissioning should go ahead apace for those GPs who are ready for it, but that the deadline should be extended for those who are not.

And there is widespread acknowledgement that plenty will not be.

I imagine that developing that RCGP line was a pretty tortuous process, and a difficult one in particular for the college's chair, Professor Steve Field.

Professor Field himself is an enthusiast for GP commissioning – he's been quite open about that, behind the scenes at least – so it must have been tricky to balance his own views with the rather more sceptical opinions of some members of RCGP council.

Particularly the Scottish ones apparently… because as Professor Field admitted to me, ‘Scotland didn't like this'.

Still, at least the college has secured its balancing act for now. The GPC still has its to come, and the signs aren't looking good.

Negotiators have cancelled this week's press conference on the grounds that there's nothing to report, but it seems rather more likely that there's nothing printable to report.

GP leaders are noticably jumpy, nervous perhaps at the prospect of attracting the big guns of the DH. So they're presumably pretty happy to see us drawing their fire.

By Richard Hoey, Pulse editor