GPs gain control of frontline care

Released 12/07/2010

Revolutionary White Paper to be released today

GPs are to be given sole responsibility for £80bn of England's NHS budget in what some are calling the biggest revolution in healthcare since the establishment of the NHS, a government white paper due out today will suggest.

GPs will be given responsibility for commissioning health services in their local area, which means they will be held accountable for decisions regarding frontline care for their patients.

Under the current arrangement, funds are given by the Department of Health to primary care trusts, which pay for patients from their area to be treated in hospital.

Under the new scheme, GPs - who are not currently responsible for paying for hospital referrals - would receive the money instead and pay the hospitals directly.

The Government will urge doctors to form groups to manage these billions of pounds in budgets.

GPs will also have to organise out-of-hours services and the White Paper is also expected to outline the creation of an independent NHS board to oversee health services.

This GP-led commissioning is likely to be compulsory but it does not appear doctors will be paid any more for it.

The White Paper is also expected to announce plans to get rid of England's 10 strategic health authorities (SHAs). Some reports say it may also signal the end of the PCTs. They and the SHAs together cost around £1.6bn to run, and the Government is keen to reduce NHS management by around 30%.

With the establishment of this new system, the Coalition believes GPs are better placed than managers to meet patient needs.

Speaking to the BBC on Sunday, Health Secretary Andrew Lansley said the proposals would "empower" doctors and tackle the "frustrating" bureaucracy within the health service.

"We have got to design services better and save money. GPs are best placed to do this," he said.

However, critics feel Lansley's plans could set the NHS back. James Gubb, director of the health unit at Civitas, said: "The NHS is facing the most difficult financial times in its history. Now is not the time for ripping up internal structures yet again on scant evidence base, but for focusing minds on the task ahead and really getting behind the difficult decisions PCTs, as commissioners, will have to make."

The National Association of Primary Care (NAPC), on the other hand, welcomes the central role being given to GPs. Chairman Dr Johnny Marshall commented: "The coalition's plans provide general practice with a unique opportunity to raise the bar in the commissioning and delivery of care for its patients. The occasion will not present itself again. It is vital that primary care clinicians embrace the new world open heartedly to address the clinical and professional challenges ahead."

What are your thoughts on the new proposals? We want to hear from you at julia.dennison@intelligentmedia.co.uk.

Sources: BBC, The Guardian and Telegraph.co.uk

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