Intended for healthcare professionals

Observations White Paper

GPs have reasons not to be so cheerful over commissioning plans

BMJ 2010; 341 doi: (Published 15 July 2010) Cite this as: BMJ 2010;341:c3839
  1. Polly Toynbee, political and social commentator, the Guardian
  1. polly.toynbee{at}

    It is a mystery how the hundreds of proposed consortia are to work better than the current system

    General practitioners are the masters now, running the whole shebang with £80bn to spend as they please. Some enthusiasts can’t wait. But many wise GPs will look this gift horse in the mouth with considerable circumspection. How exactly are they to do it?

    Divided into 500-600 consortia, GPs will do all the purchasing that the abolished primary care trusts did with 45% less cash for management costs. They will do it alongside the day job they chose—general practice, not NHS management. Once 303 primary care trusts did the job, but the shortage of finance directors and chief executives forced their reduction down to 150. Now all PCTs and the 10 special health authorities are to be abolished, with their staff cast to the four winds. In yet another game of NHS managers’ musical chairs, how will they be spread thin across 500 GP consortia? As happens with each turbulent reorganisation, many of the best will walk away. Civitas—a government friendly think-tank—warns that this …

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