Tories 'will bring NHS to its knees'

Primary care minister Mike O'Brien spoke to Tom Ireland about Labour plans for GPs and primary care.

Health minister Mike O'Brien claims Conservative health policy would return the NHS 'to its knees' and drive some small practices out of business.

Talking exclusively to GP at his Whitehall office, Mr O'Brien says 'last time we had an NHS on its knees and I predict that if they come back in we will have the NHS back on its knees'.

He claims many of Conservative shadow health secretary Andrew Lansley's policies have been 'dumped' by the Tories as they fight for election campaign 'soundbites'.

'You have got to have sympathy for poor old Andrew. David Cameron has taken control of health policy and humiliated him,' he explains rather unsympathetically.

The Conservatives' latest draft health manifesto, launched by Mr Cameron this month, announced more funding for deprived PCTs, which 'already happens under Labour', says Mr O'Brien. 'So does it mean shire counties will now get less funding?' he asks.

Mr O'Brien is not as comfortable when asked about some of Labour's policies that could also be described as being a mess.

GP's latest poll found more than half of GPs (59 per cent) think practice-based commissioning has been a failure, and the same percentage have no involvement in the scheme.

Click here to see results of poll

Mr O'Brien struggles to explain how Labour will get the flagging policy off the ground without forcing GPs to do it.

'We expected more to do it than have done. Some GPs just do not want to be businessmen, they want to be doctors.

'My concern is that the Conservatives will make it compulsory and that will put some GPs out of business,' he warns.

GP's poll reveals 46 per cent of GPs think Tory health policy is best, despite just a third (29.5 per cent) supporting their plans to force GPs to commission.

Practice boundaries
Another Labour policy failing to garner support from GPs is the decision to scrap practice boundaries - opposed by three quarters (78 per cent) of GPs.

Mr O'Brien understands why GPs are worried about the policy, but again fails to explain how it can be implemented successfully.

'GPs are not sure about how it is going to happen and therefore they are worried about it, and opposed to it. I understand that.

'Others may still oppose it, but I just say to them, how do you justify looking a patient in the eye and saying "you might want to go and see that GP but I am not going to let you"?' A consultation on how it could work will be published soon, says Mr O'Brien.

What if Labour scrapes an improbable election victory this year? The minister says GPs should expect to do more to treat patients with long-term conditions at home.

'I want to stop people with long-term conditions Yo-Yoing in and out of hospital. The sys-tem at the moment is calculated to encourage admission.

'We see GPs being much more involved in the way care is delivered in the community, so people are treated at home more and GPs do not hand over the care of these conditions to hospital.'

GPs under pressure?
Mr O'Brien says that GPs' status as independent contractors is safe with Labour. Smaller practices will be expected to work together and share services, but otherwise the government does not plan to start 'intervening in the way in which individual practices develop'.

Ministers' obsession with extended hours is not over - Mr O'Brien hints it may be introduced into GPs' contract.

'We are trying to get GPs to extend their hours,' he says, despite the fact that at least 77 per cent of practices are now open late and at weekends.

'There are a significant number of patients for whom being able to see a GP at a time of their choice is important.

'To others it may not be. But as the world changes ... the way in which GPs provide services and the way the contract develops will need to change.'

Mr O'Brien accepts that GPs have been under pressure in recent years to do more and more work. But he hopes that GPs will view Labour's latest aspirations as an opportunity to improve their health service.

'We are looking for GPs to take a greater role in terms of how money from PCTs is spent and managing the long-term care of their patients. So, are these more pressures? I think GPs will see it as a greater level of control over things they set out to do when they came into the profession.

'I know we have put some pressure on you (GPs) but things have got better - but we have not got it great yet. With the help of health professionals we can get it from good to great.'

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