One hundred years after its birth, is it, and LMCs (some of which are slightly older) fit for purpose?

Whatever your thoughts about the Health Bill, one undeniable consequence is that it gives GPs greater control over clinical commissioning groups (CCGs), the bodies designed to replace PCTs.

Speak to LMC representatives and they will tell you that ahead of CCG authorisation they are pulling out of involvement with CCGs, to enable them to speak with an independent voice and to avoid any accusations of conflicts of interest.

In the new order, commissioning GPs will have these potential conflicts of interest to consider and LMCs will play a vital part in promoting the best interests of the GPs they represent.

CCGs seeking to address practice variation could easily slide into the sort of behaviour synonymous with PCTs; target setting and punishment based on poorly conceived ideas of what brings about 'good' and 'bad' performance.

Reforms pit GP against GP because so many managers have been removed from the bodies that are becoming CCGs. It is imperative for GPs to have representation in any argument with a CCG, and who better to do this than the LMC, which will be forging a good working relationship with the CCG? Perhaps these debates will not be quite so adversarial, with GPs on both sides.

The possibility of an end to the UK-wide contract, which becomes ever more likely should Scotland become independent, also means the GPC will have a great deal to consider to maintain the unity and strength that representation of a larger number of GPs brings. Who would have dreamt that the GPC and LMCs would be as relevant in 2012 as they were 100 years ago?