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Think GPs are running the commissioning show? ROY LILLEY urges you to think again
GP-led commissioning dies the death
ROY LILLEY
is a regular columnist in Practice Business. He is also an independent health and policy analyst, writer and broadcaster and commentator on health and social issues
I
came across a really interesting statistic. I know numbers can be manipulated and fiddled; I also remember the old joke: ‘He used statistics like a
drunk uses a lamppost’. Undaunted, I shall press on. The statistic came from a poll in one of the GP
trade magazines. It is astonishing. Don’t read any further if you are standing up. Sit down and make sure there is a cup of warm sweet tea at hand. You may well go into shock. Here it is: Nearly 60% of CCGs do not have a
GP on the board. Shocked? There is more. Back in May I discovered another statistic: Only 22% of CCGs have a GP as the accountable officer. Well, are you shocked, surprised, astonished,
amazed? Are you stunned, astounded or flabbergasted? Think about it: The whole purpose of the
‘liberation’ reforms was to put docs in the driving seat. There was a huge row about it. Do you remember? The massive bill that turned the NHS inside out and upside down; the palaver, the pause, the arguments, the stuttering passage through the House of Lords; trench warfare. The GP community was split. They could
have walked away, they could have said to the then secretary of state, Andrew Lansley: “We don’t want to do this.” The GPs could have walked away. The BMA, the GPs’ trade union, was split, the Royal College of General Practitioners membership didn’t back the opposition voiced by its leadership. The GPs couldn’t be bothered, didn’t see the point, or genuinely thought it was a good idea. So, am I surprised that GPs are walking away
from the actuality of the Health and Social Care Act? Am I surprised that GPs, busy up to their eyes in practice and appointments, paperwork, guidance and all the rest, are giving running a
10 october 2013
CCG a miss? Am I surprised that GPs, some of the highest earners in the NHS, can’t be bothered with the mind-blowing monotony of committees, working groups and meetings? No, I am not surprised and, to be honest, I
doubt that you are either. We are well on the way to seeing PCT-light
returning to healthcare. The names might be different but the tasks and the jobs are the same. Here’s another statistic: One in five managers
who lost their job in last year’s cost-saving redundancies has returned to working in the NHS. Surprised? ¾
GPs are walking away from the actuality of the Health and Social Care Act
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