Amend the Health Bill to give GPs faith in reform

Even before the 400-page Health Bill itself saw the light of day, GPs feared plans to drive up competition between NHS providers would limit their commissioning role.

Now that the Bill has emerged, the powers it hands to Monitor - the foundation trust regulator that will expand to enforce competition law across the NHS - have done little to ease those fears.

GP reported last week how the regulator will issue economic licences to providers and be able to revoke them for 'anti-competitive conduct'.

The BMA fears the rules will curtail collaboration between GPs and their hospital colleagues. Conservative MP for Totnes and GP Dr Sarah Wollaston has said every decision GP commissioners make may be subject to scrutiny and competition law.

Leading GPs close to the DoH, including national clinical commissioning network lead Dr James Kingsland and former primary care czar Dr David Colin-Thome, have taken a different view, urging their GP colleagues not to be put off.

But a statement in this week's GP from the interim chief executive of Monitor, David Bennett, could be a first step towards easing the fears of NHS reform critics. Mr Bennett says consortia will be able to sidestep competition rules if they can show this is in the interests of patients.

He urges GPs not to listen to 'alarmist' talk about the NHS reforms.

But as the GPC points out, the Health Bill in its current form hands sweeping powers to the regulator.

For all but the most ardent believers in the NHS reforms, it will not be enough to hear Monitor, or the DoH, promise to apply these powers sensibly.

If the government wants GPs on board, it must listen to the profession, and include clauses in the Health Bill to explicitly limit Monitor's powers and lay GPs' fears to rest.

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