Chris Lancelot: There is nothing wrong with showing caution

The difference between brave people and cowards isn't that the brave feel no fear: rather, they feel the fear, but choose to face it.

The GP Record, by Fran Orford
The GP Record, by Fran Orford

I think our response to the White Paper should be just that.

For decades the profession has been saying that having non-clinical managers in charge of the NHS is a disaster. Now we have the chance to change things completely. We GPs are to be given control of 80 per cent of the entire NHS budget. What an opportunity. What a responsibility.

Suddenly it's time to feel uneasy. It's all very well sitting on the sidelines, rubbishing NHS management but it's altogether different when we're the ones making the decisions. The enormity of the task is all too clear - as is the responsibility.

And it's no bad thing to think like this. Realism is helpful. The worst operatives are those who think they know it all. The best are highly aware of their personal limitations, yet prepared for the sake of excellence to ask others for their advice, consider the options - and then bravely grasp the nettle.

That's where I see the profession at the moment. The White Paper presents us with a unique opportunity to do just what we have been requesting for years. Personally, I have no doubt we will be up to it. For a start, we won't be doing the work directly: we will be in charge, while appointing managers to carry out our decisions. But that's the point: although the practice manager is the chief administrator, the clinicians are in ultimate control.

Under the White Paper, GPs will face a similar task - to form an elected board whose responsibility is not to do the work itself, but to appoint and guide managers who act on their behalf.

Won't we all need to acquire management expertise? Not at all. Many of our colleagues already have managerial and entrepreneurial skills. I'm sure they will be the ones who will actively seek election, then capably shoulder the burden. Nevertheless, there will be much for us all to plan - and the size and breadth of the task is enormous.

So it's good that we are wary: with wariness comes thought, with thought wisdom, and with wisdom progress.

And fortune favours the brave.

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