Consortia 'will inherit PCT deficits'

Leading GPs warn starting with deficits will doom GP commissioning to failure.

Dr Vautrey: 'If there is an inherent deficit then consortia will have to work with that' (Photograph: Wilde Fry)
Dr Vautrey: 'If there is an inherent deficit then consortia will have to work with that' (Photograph: Wilde Fry)

PCT debts are likely to transfer to GP consortia when the profession takes on commissioning, senior GPs have warned.

Starting off with millions of pounds worth of deficits will mean GP commissioning is doomed to fail, a raft of organisations have warned.

The NHS Alliance says the issue will become a 'deal breaker' in deciding whether GPs embrace the plans.

Dr David Jenner, GMS/PMS lead at the NHS Alliance, said he believed 'the default position' will be that existing PCT deficits are passed on to the consortia that replace them.

'It will make it really difficult for them,' said Dr Jenner. 'If your pay will be linked to performance - what if your performance starts on minus three, rather than zero?'

GPC member Dr Nigel Watson said GP commissioning would be a 'non-starter' if consortia had to begin operating with large deficits. 'If you're going to be a consortium's accountable officer why would you take that on starting with a deficit?' he said. 'They have to resolve this.'

Recent research by The Guardian found a third of PCTs had deficits at the end of 2009 totalling around £130 million. But Dr Jenner said as many as three quarters were hiding debts by borrowing money from other trusts.

A DoH spokeswoman could not rule out consortia taking on PCT debt, but said the matter was up for discussion during the consultation period.

NHS Alliance chairman Dr Michael Dixon said 'chance and windfall' should not decide what commissioning budget GPs start with. That would be 'the deal breaker for me and others', he said.

But GPC deputy chairman Dr Richard Vautrey said it was 'inevitable' that GPs would be commissioning under difficult financial conditions.

'If there is an inherent deficit then consortia will have to work with that,' he said.

Dr Jenner called for PCT debts to be transferred to the NHS Commissioning Board, 'as it is taking on most of the functions of PCTs'.

He advised 'all GPs' to respond to the consultation on the White Paper Liberating the NHS.

'Unless GPs raise this as a really big issue they will get saddled with these debts,' he said.

The GPC, RCGP, NHS Alliance, Family Doctor Association and National Association of Primary Care (NAPC) have been meeting to form a consensus on the White Paper before the consultation period ends.

NAPC chairman Dr Johnny Marshall said the groups were attempting to find 'a common agenda' so the profession could 'speak with a shared voice'.

'It's very much about how we are going to do this (GP commissioning) - not whether it is a good idea,' he said.

Dr Vautrey said contract discussions with NHS Employers have begun and both parties were 'mindful' of agreeing a deal by November, when evidence is submitted to the Review Body.

What the future holds for commissioners
GP consortia may be forced to inherit millions of pounds of debts from PCTs when they are formed.
  • The GPC has warned difficult financial conditions for commissioners are 'inevitable'.
  • Leading GP organisations, including the GPC, RCGP and others, are attempting to build a consensus on how to engage with the government's White Paper plans.
  • The GPC has begun negotiations with NHS Employers.


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