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Most GPs feel like a deer in headlights

History may not be very kind to our health secretary Andrew Lansley when the dust settles in a few years' time. He will be credited as the man who broke the NHS.

Motives abound for this of course, many of which are dressed up as the absolute need for change, but it is actually privatisation by the back door.

If my experience as a board member of a commissioning consortium is anything to go by, then I suspect thousands of GPs are confused, bewildered and feel like deer in headlights.

This does not bode well for the doctor-patient relationship, because our new roles will require rationing, cost control and financial management to be at the centre of our consultations, rather than the patients' needs.

The NHS is simply vast, but unlike the banks it is not too big to fail. And when the smog clears in a few years' time, we GPs will be blamed for much that has gone wrong.

Our real hope as commissioners lies in a true managed care organisation that would free us from some of the mess that being a consortium will create.

On current form, consortia will be mini-PCTs with none of the innovative freedoms that a managed care organisation could allow. So, good luck Dr Hamish Meldrum, you have a difficult role as chair of the BMA right now.

From Dr Nicholas Down
Oxshott, Surrey