The Health and Social Care Bill currently making its way through the parliamentary process has caused quite a stir in the NHS. The Secretary of State for Health, Andrew Lansley, decided that GPs know best and should therefore commission NHS resources. Although change was expected, for many working in the NHS the move to put GPs in charge of the majority of the commissioning budget has come as quite a surprise.
The reforms proposed made by Lansley have divided opinion among GPs, hospital doctors and other healthcare professionals. Most would agree that GPs will often know what is best for their patients individually, but the question is whether this understanding stretches to the needs of the many.
The concern that communication links between the proposed GP consortia and service providers will not be strong enough is one that is held by current commissioners working at Primary Care Trusts (PCTs) across the country. At present, the PCTs work closely with service providers when commissioning different treatment programmes or commodities. When the GP consortia take over this role, there will be nothing to replace the knowledge formerly provided by staff from many different healthcare backgrounds.
A further concern is the amount of money it will cost to lose the staff currently employed in the Primary Care Trusts; the commissioners being made redundant will be given severance packages before GPs take over their role. This is a considerable expense at a time when the country is somewhat strapped for cash.
The loss of staff from the PCTs risks engendering an over-stretched workforce elsewhere. GPs in the new consortia might end up being isolated from the rest of the NHS, working in roles that will require more time handling accounts and less time on the ground doing what they were trained to do – treating patients. Others are concerned that there will be a conflict of interest for GPs and they will no longer be able to act as advocates for their patients. After all, how can a GP fight for an expensive treatment for one of his or her patients, if that same GP sits on a commission determining resource allocation for the rest of the region?
The issue many NHS staff have with these changes are the speed with which they are being brought in. With hardly any pilot studies and little evidence to support the benefit of these reforms, it’s hard to know how this will turn out. Some think that if they are implemented correctly, the reforms have the potential for success, others believe that they will fail. Either way, the reforms are already being rolled out, so we’ll find out soon enough how GPs will be able to cope with these additions to their job descriptions.
Picture Courtesy of Creative Commons. Photographer Sebastian Zwez







What people are saying