GP Commissioning: A Mistake?
I’ve talked to just one person in the private sector in England who thinks that the move to get family doctors to buy everything (so called GP commissioning) is a good thing.
Essentially, it involves removing the 150 or so primary care trusts which currently buy services for districts and giving the work to new GP commissioning agencies which have yet to be formed. There might be anything up to 600 of them. The Primary Care Trusts were regarded as not very bright but the new move worries everyone.
As the head of one hospital group said: “For about two days I had all this schadenfreude about the destruction of these PCT commissioners and then I started worrying about the replacement. It was a bit like the Iraq war. I liked the shock and awe and then realised there would no infrastructure left.”
This is the concern. A PWC source said: “It is like replacing organistions with little brains with organisations with no brains at all. You might get away with it in years when your budget is increasing by 5% but when you are looking at making efficiency savings of 20% over four years it is a recipe for disaster.”
Nor is it clear that the change will be good for the private sector. One commissioner told me that, if cuts had to be made, then elective surgery outsourced to private hospitals would be top of his list. “They cherry pick already and if things go wrong the patient comes straight back to the NHS anyway. Why should I prioritise them over local NHS hospitals?” The concensus is that the private sector will have to cut prices to keep business and no one knows how price sensitive the new purchasers will be.
We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.
