Watson Esam | News | Big changes ahead for GPs

So now we know what is happening.  Or do we?  The government has clarified its goal, with the White Paper published on 12 July and £80bn commissioning budget being passed to GPs with no opt-out.  The changes go further than many had anticipated with the wholesale abolition of Strategic Health Authorities, Primary Care Trusts and many quangos, thus at a stroke de-layering the bureaucracy which has beset GPs.

The White Paper and consultation is where the battle over the detail will now be fought.

There is no doubt that the only real game in town for the government is getting the GPs on side in sufficient numbers to push through the changes.

Since the Labour Government scrapped fundholding by GPs in 1998 soon after it came to power, GPs have had little financial control over patient access to services but they have begun to enjoy freedoms and incentives themselves under their own contract with their PCT and practice based commissioning.

What will it take for GPs to support the new proposals?  We suggest the following: first, a further de-layering of administration including the de-cluttering of all the politically correct (i.e. non-clinical) agendas from the national outcomes when they are agreed (imposed?).  Secondly, practical assistance and guidance from the proposed NHS Commissioning Board to help GPs form consortia in order to carry out commissioning functions and help with commissioning itself.  Thirdly, ensure that NICE and the Care Quality Commission, which are to have oversight and monitoring of all standards, do not merely replicate the abolished organisations.  And fourthly, flexible patient consultation time – which should be achievable out of the savings in bureaucracy.

If the government can deliver on these it will have secured its main ally.

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