GPC chairman Dr Laurence Buckman condemned the government’s failure to scrap plans to offer successful clinical commissioning groups (CCGs) a ‘quality premium’ bonus payment.
‘We are not going to have one. It is in the Bill still – it should not be, it is an inappropriate use of public money.’
Dr Buckman said the quality premium was ‘ethically dubious’ and not acceptable, suggesting that if the government had spare cash to hand out, it should ‘give it to the poor’.
‘We think it is utterly immoral to take some of the money out of patient care and give it to GPs.’
GPC negotiators questioned the logic behind growing pressure on CCGs not to form around small population sizes, and warned that the government was rapidly pushing the NHS back into structures similar to the ones it had just spent billions of pounds to dismantle.
In addition, many experienced managers ‘who know how to run an NHS’ had been expensively laid off and lost to the health service.
He pointed out that the government had initially had a ‘laissez-faire’ approach to the establishment of CCGs but had now performed a volte-face and was dictating how they should look.
GPC negotiator Dr Chaand Nagpaul said: ‘The key difference of CCGs from PCTs should be the sense of ownership by GP practices within them.
‘We run a real risk of that ideal vanishing in the context of a largely bureaucratic process of authorisation.’
GPC leaders said that PCT clusters were ‘bearing down’ on CCGs to impose minimum population sizes.
Dr Nagpaul said: ‘It begs the question, why did the government approve all these pathfinder sites if they were never going to be fit for purpose?
‘It is very demotivating to do this only to be told later that what you have agreed is no longer sustainable.’
GPC deputy chairman Dr Richard Vautrey added: ‘Huge numbers of GPs have invested a huge amount of time and goodwill and money in some cases, and it’s come to nought.’
He said the mishandling of the reforms would leave the NHS with no more clinical engagement than existed before the Health Bill.