15 October 2010
GP commissioners should lose their contracts with the NHS if they fail to manage their practice budget, a primary care trust chief has said.
In an article published in the British Medical Journal today, Danny Ruta, joint director of public health at Lewisham PCT and the London Borough of Lewisham, says GPs have been reluctant to consider the financial implications of decisions they make. The health white paper’s proposal to give power to GPs is a welcome move, he adds.
‘In effect, the white paper’s proposals force the group of doctors whose interests are arguably most closely aligned with the needs of the population to consider the opportunity cost of their clinical decisions so that they can maximise health gain for that population and reduce health inequalities with the resources available to them,’ Ruta writes.
But he warns that any positive changes to come from the white paper will be lost unless the government sufficiently punishes GPs who fail to manage their practice’s finances.
‘The government must negotiate with the British Medical Association to impose the ultimate sanction on GPs who repeatedly fail to live within their means and fail to control their commissioning budget: they must lose the right to continue to work for the NHS,’ he says.
A spokesman for the NHS Confederation PCT Network told Public Finance that it has no view on what sanctions might be placed on failing practices, but urged ministers to clarify them as soon as possible. He said the arrangements set out in the white paper were ‘not clear’.
A BMA spokeswoman said Ruta's view was not one the association would agree with. 'The BMA believes there are other ways to ensure effective use of resources within individual GP practices that are part of a consortia. Peer pressure, in particular, has been shown to be a good incentive when it comes to making practices look at and improve their efficiency,' she said.
