By Richard Johnstone
9 May 2011
Wholesale reorganisation of the health service is unnecessary, GPs said today, casting further doubt on the government’s controversial reform plans.
In a letter to Prime Minister David Cameron,the Royal College of General Practitioners lists a series of changes it wants made to the Health and Social Care Bill to protect the principles of the NHS.
The college represents more than 42,000 GPs, who are set to be given responsibility for £60bn of the NHS budget and to take over commissioning from primary care trusts. The GPs want the government to change or clarify nine areas of the Bill, which would also open up provision of services to ‘any willing provider’.
The legislation was ‘paused’ last month by the government for further consultation. More recently, the Liberal Democrats have indicated that they will be seeking significant changes to the Bill.
Today’s letter highlights GPs’ concerns over a ‘lack of clarity’ over the impact of the new regime on patients. They say that no assurances have been given that services will be protected in the desired competitive market, pointing out that the Bill does not include a duty on the health secretary to provide a comprehensive health service throughout England.
They also call for clarity that the GP consortiums, which would take over commissioning, would be able to collaborate without fear of a competition referral from Monitor, the proposed economic regulator.
The letter, which was also sent to Deputy Prime Minister Nick Clegg, Health Secretary Andrew Lansley and NHS chief executive Sir David Nicholson, states that GPs would support a different type of reform – the development of primary care federations made up of GP practices as well as social, mental and community care providers.
College chair Dr Clare Gerada said that GPs acknowledged that the NHS needed to change and the college was not opposed to reform.
But she added: ‘The reforms promote competition without sufficient clarification of how services to patients will be safeguarded and improved. We believe that provider-side reforms could deal with many of the issues without the need for repeated organisational change or by many of the proposed reforms.’
