12 November 2004
The initiative giving GP practices the power to commission care for their patients should not extend to mental health services, a leading charity said this week.
The Sainsbury Centre for Mental Health said practices could make decisions on mental health services that were based on cost rather than on individual patient's needs.
Mental health has been omitted from the new payment by results (PBR) NHS funding system because of the complexity of the services. Standard tariffs will not be applied to mental health until it is included in PBR.
Since service providers will be able to compete on prices, and GP practices will have incentives to make savings on their budgets, the charity said practices might choose the cheapest option, which might not be the most appropriate.
It also warned that the information technology needed to help GPs and patients make informed choices about treatment was not available.
Dr Alan Cohen, the SCMH's director of primary care, said that practices could commission 'talking therapies' for common mental health problems such as depression but that primary care trusts should commission most mental health services for the time being.
'Practice-based commissioning is the logical conclusion of the government's NHS reforms. But it will not work for patients unless we can be sure that all services are of sufficient quality, that choices are supported by good information and that cost considerations do not distort decision-making,' he added.
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