The BMA says more thought should be given to what happens if a practice is expelled from a consortium, and how it could join another group. The report points out that this may be difficult if there is no other consortium with a geographic, local authority or health economy link to the expelled practice.
GPC deputy chairman Dr Richard Vautrey added that GP contracts should not be jeopardised if a consortium fails. GPs may lose their right to make commissioning decisions, but should still be able to provide services, he said.
Overall, the BMA response says that while it backs elements of the White Paper, some of the reforms could 'undermine the long-term future of the NHS'.
The BMA raised concerns that reforming the NHS will cost a 'large amount of money' at a time when attempts are being made to release £15-20 billion of efficiency savings.
Dr Richard Vautrey said: 'We do question whether the wholesale removal of PCTs and replacing them with GP consortia is necessary. We question whether there would have been a more cost-effective and indeed quicker way to ensure real, meaningful clinical engagement.'
The BMA also warned of the potential to create a 'vacuum' in PCTs if skilled managers and staff leave their jobs.
It said: 'If handled poorly, there is a real risk of PCT implosion, which would require a dramatic shortening of the proposed timeline, even if consortia were not fully capable of stepping into the role.'
The BMA response also calls for further detail on how PCT debts will be managed. It warns passing them to consortia could prevent the groups from functioning to their full potential and discourage GPs from becoming involved.
