Intended for healthcare professionals


General practitioner commissioning groups

BMJ 2011; 342 doi: (Published 28 April 2011) Cite this as: BMJ 2011;342:d2667
  1. Nigel Edwards, acting chief executive1,
  2. Naomi Fulop, professor of health and health policy2
  1. 1NNHS Confederation, London SW1E 5DD, UK
  2. 2King’s College London, London, UK
  1. nigel.edwards{at}

How they are held to account and governed matters; the government has a difficult balancing act

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 …

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