NHS reorganisation forces GPs to choose between patients and CCGs, warns BMA

The Health and Social Care Act has created an “untenable conflict” between GPs’ professional obligations to patients and their statutory obligations to local commissioning groups, the BMA has warned.

The BMA said that practices’ responsibility to comply with the statutory obligations of their local clinical commissioning group (CCG) include staying within budget and meeting managerially driven targets. This will place “significant obstacles” in the way of practices acting in their patients’ best interests, the BMA’s General Practitioners Committee warned.

Laurence Buckman, the committee’s chairman, said, “We think GPs need to be very careful when looking at their commissioning role that they don’t feel conflicted between that role and their role as carers for patients.”

The committee’s GP negotiator, Chaand Nagpaul, added that GPs have been required to join CCGs against their will. “[The act] forces GPs to be members of these organisations and forces them to be bound by the rules of that organisation even when they explicitly dissent from the view of that organisation,” he said.

In a motion passed at the latest meeting of BMA GP representatives, the General Practitioners Committee said that compulsory practice membership of CCGs would compel practices to be “integral agents of state rationing, cost control, and privatisation.” As such the government’s changes to the NHS seriously threatened the relationship between GPs and patients and posed a risk “to the very integrity of NHS general practice,” it said.

Practices might find themselves having to limit their engagement with their CCG and its activities to just their contractual obligations to be able to prioritise the provision of safe essential services, the committee believes.

The General Practitioners Committee has called on the BMA and local medical committees to robustly support GPs who make the interests of their patients their first concern. GPs should not comply with obligations placed on them by the constitution of their CCG where there is evidence that patients’ safety might be compromised by the requirements of CCG policy, it added.