Editorial: PCT meddling puts White Paper reforms at risk

The consultation period on the White Paper Liberating the NHS draws to a close this month.

But GPs still face a lengthy wait for final guidance on the roles, responsibilities and, crucially, the funding of commissioning consortia.

GP newspaper reports this week that in some areas, plans for consortia are starting to take shape, as GPs prepare to assume a reinforced role at the heart of a re-shaped NHS. These early efforts to act on the White Paper reforms reflect the profession's willingness to engage with health secretary Andrew Lansley's plans.

But in the period of limbo as PCTs are wound up and consortia have yet to fully evolve, GP leaders must be vigilant to ensure this goodwill is not undermined.

PCT Network director David Stout reminds GP optimists this week that there is unlikely to be any new money in the system to incentivise commissioning.

QOF could be raided to encourage GPs to get on board, in addition to the chunk of existing funding that will be top sliced to pay a 'quality premium' to successful consortia.

Reports this week that some PCTs have sought to divert extended hours cash - a block of funding GPs should be guaranteed through the GMS contract - to fund the establishment of consortia are alarming.

LMCs must be on their guard to prevent cash-strapped PCT managers with months left in their jobs stripping what they can from GP pay to help hit their savings targets.

The DoH has given a laudable commitment to allow consortia to define locally much of their structure and how they operate.

But reports suggest a handful of PCTs are attempting to subvert these freedoms, by seeking to appoint the GPs who will lead consortia, and by pushing practices into groupings against their will.

Ultimately, the reform plans depend on GP support. Unless the abuses of GPs' income streams and freedom to shape consortia stop, the legacy Mr Lansley hopes to leave may unravel.

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