The proposed accountability and governance arrangements for the new general practitioner commissioning consortiums have become an important political matter. The government has said little about these questions to avoid accusations of top down direction. This has backfired because the lack of detail has been seen as worrying vagueness. The Health Select Committee took a very critical view of this,1 and some Liberal Democrats have also made it clear that changes are needed.2 3

There are several concerns. Firstly, will the consortium have governance that is adequate for the large responsibilities and budgets they will hold? Secondly, will they be open and transparent? Thirdly, how will they be held to account nationally and locally? The government could have been more confident about taking a position because a large literature is available on what constitutes good governance.4 5

Some of the concerns about the governance of general practitioner commissioning consortiums that relate to their conduct and transparency can be tackled by simply applying standards that already operate for other public bodies. These include public meetings, published minutes and papers, clear decision …