Consortia can revive 'corpse' of PBC

The former DoH primary care czar who declared practice-based commissioning (PBC) a 'corpse' has backed the current NHS reforms to reinvigorate GP commissioning.

Dr Colin-Thomé: reforms are best opportunity for GPs in 40 years (Photograph: Bob Clayton)
Dr Colin-Thomé: reforms are best opportunity for GPs in 40 years (Photograph: Bob Clayton)

In his first interview since retiring from the DoH, Dr David Colin-Thome called the reforms 'probably the most exciting opportunity I can remember for enhancing the scope and influence of general practice in my 40 years as a doctor'.

He rejected fears that the government's any willing provider policy was a blueprint for NHS privatisation, and said it could create 'huge possibilities' for partnership working.

Speaking exclusively to GP, Dr Colin-Thome said GP consortia would succeed where PBC failed. 'PBC depended on the existing commissioners giving GPs some responsibility, power and influence. That happened in some places, but certainly only in a minority. Now GPs are the leaders as commissioners, and I think that's ideal.'

Dr Colin-Thome said handing GPs commissioning powers would trigger a more systematic shift of services into community settings. Progress on this to date has been 'poor', he admitted.

Dr Colin-Thome said the reforms were evolutionary and not 'big bang'. The only thing that has changed is the leadership of commissioning, he said.

'For the average clinician little has changed, except for the much needed idea that clinicians should be leading on commissioning,' he said. 'Nobody is taking hospitals or GPs away from looking after patients.'

Dr Colin-Thome said it was too simplistic to say that the foundation trust regulator Monitor - which will expand to enforce competition among all NHS providers - will constrain GPs' commissioning decisions.

He said its role will be to prevent anti-competitive activity, but this does not mean there always has to be competition.

'Where people have got the skills, Monitor will make certain that they are allowed to be part of the process,' he said.

'Life is never as black and white as it is popularly portrayed,' he said.

'It is not a bleak threat that the terrible private sector is going to destroy all that is good. I just think that it's over-egged.'

Dr Colin-Thome said the any willing provider policy could open up new models of partnership working, with a broader range of providers keen to collaborate with GPs.

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