GPs 'to get control of NHS funds'
Updated on 12 July 2010
The government announces a health White Paper outlining new budgetary powers for GPs in the biggest shakeup to the NHS in England in 60 years, writes Channel 4 News correspondent Victoria Macdonald.
At the Firs House Surgery is Histon, Cambridgeshire, they have been preparing for today's announcement for months. With the co-operation of their local primary care trust (PCT), they and other surgeries across the county have formed themselves into seven consortia, the first to be ready to run later this month.
With the encouragement of NHS Cambridgeshire PCT, they will be responsible for 80 to 90 per cent of the budget, which will be used for commissioning services for their patients. This could be anything from bunion surgery to transplants.
Health secretary promises patients more choice
Health Secretary Andrew Lansley announced changes for the NHS in England and confirmed that GPs would be given a far greater role in commissioning services for their patients.
He told MPs that both strategic health authorities and primary care trusts would be phased out in the drive for greater efficiency. And he said unjustified targets and bureaucracy would also go to help realise up to £20bn in efficiency savings by 2014 - to reinvest in patient care.
Lansley said the NHS remained "stifled by a culture of top-down bureaucracy" which blocked the innovation of staff.
An independent NHS Commissioning Board will oversee the new regime, with local councils taking over the public health element of PCTs' work.
Under plans set out in a White Paper, the Government also promised to scrap "top-down" targets in favour of a regime based on clinical outcomes.
Shadow health secretary Andy Burnham hit back and accused Lansley of a "U-turn of epic proportions" by "ripping-up" the coalition agreement on the NHS.
"This reorganisation is the last thing the NHS needs just now. It needs stability not upheaval," he insisted.
Professor Chris Ham, chief executive of the King's Fund, told Channel 4 News there would be costs caused by the changes.
"Clearly it is going to cost more money." he said.
"There'll be redundancy for people currently employed in the NHS who won't have jobs in the future.
"There'll be about 600 GP groupings controlling budgets compared with 150 PCTs today. They will need their managers to do the work on their behalf.
"For hospitals having to negotiate with a larger number of smaller buyers of healthcare there are all the transaction costs associated with that. We don't know whether there will be a net saving or not."
The GPs in Cambridgeshire believe that there should be no profit-making element to the scheme and that it should be voluntary. The announcement is effectively the biggest shakeup of the NHS since it was formed 60 years ago - despite the coalition's promise that there would be no more 'top down' reorganisations.
Do GPs want this to happen?
While the College of General Practitioners welcomes giving more powers to doctors, a GP writes for Channel 4 News on the anxious uncertainty ahead.
Read the article here.
The shake-up will see GPs given £70bn of the NHS budget, primary care trusts will be stripped of most of their functions and there will be an independent health board to oversee the commission (or purchasing) of care.
What will patients see on day one? Dr Simon Poole, at Firs House Surgery, said they will not notice anything different, especially on day one. But he believes that family doctors are best placed to know what care their GPs need rather than having it dictated centrally.
"GPs will be much more in the driving seat in the way patient care is organised because GPs are best placed to know the needs of their local population," he said.
More from Channel 4 News
- Warning over £80bn GP fund-holding plans
- A&E unit closure dilemma for Andrew Lansley
- NHS cuts: key Labour health targets axed
The reason they did not want to take a profit was precisely because of concerns that it is equivalent to accepting inducements to treat patients. What they do not want to happen is for a patient to be sitting across from the doctor only to be told they cannot have an operation because it might tip the consortia budget into the red.
It is not clear yet how many GPs actually want to have responsibility for their budgets. Some estimates are that only five to 10 per cent are ready to go now and that perhaps 50 per cent will be in 18 months.
But there are a number of private companies who will offer the services, especially in purchasing care, to GPs lacking the confidence to deal with the complexities of NHS spending.
