I support your campaign for a clean slate when GPs take over commissioning.
It will be hard enough to deliver the same service with year-on-year reductions in our budget – even if we start from zero. The NHS has a target to save £20bn in four years, which will require sweeping efficiency savings and innovative new ways to deliver care. If PCTs hand over a ship that is already taking on water, we will capsize.
The proposals also take no account of the legal implications of asking GPs to manage demand. We will need some protection or indemnity against complaints caused when we refuse access to certain treatments. The doctor-patient relationship will be a serious casualty. Reducing the role of NICE and asking GPs at the front line to make decisions on treatments that are beyond their competence is unacceptable.
We are already burdening GPs with conflict of interest in expecting them to be both commissioners and providers. To burden them further with debts is a non-starter.
From Dr Kumar Kotegaonkar
Bury
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