DH must 'allow GPs freedom for reforms to work'

The government must relinquish control of local decision making for the NHS reforms to succeed and to keep GPs engaged, a clinical commissioning group (CCG) chairman and former MP has warned.

Dr Howard Stoate: GPs need freedom to make reforms work
Dr Howard Stoate: GPs need freedom to make reforms work

Chair of Bexley CCG and former Labour MP Dr Howard Stoate said GPs’ hearts sink when he explains the bureaucracy his CCG has to undergo to be authorised by the NHS Commissioning Board (NHSCB).

Speaking at an all-party parliamentary group on primary care and public health meeting on the health reforms yesterday, Dr Stoate said that if the government insists on a ‘heavy touch’ it risks killing the reforms.

He said: ‘The government has got an issue it has to resolve, which is that the initial intention was localism. The idea was that if you were to devolve power down to local groups they would make local decisions for local people and local clinicians will be in the driving seat working with their local communities, patients and with the local authority at a local level. However the command structure for the DH has actually pretty much made that a much more difficult task. It can’t quite relinquish central control.

‘On the one hand, localism is the watchword, and on the other hand command and control and centralism is very much the way it is being driven. It does make the job of people like me and my colleagues across the country rather more difficult.’

Dr Stoate said there was more bureaucracy than anticipated and that authorisation is ‘proving quite technically difficult’.

He said: ‘We had a year of trying to engage with GPs. In Bexley we are very engaged with our practices but you could see their faces fall when you explained the latest round of bureaucracy you had to go through - a constitution, setting up a CCG, explaining the legal hoops to go through to get there, the governing body, probity, all the governance issues - huge amounts of it.

'You could see their hearts sinking because they were saying: "What about the clinical stuff?". I think we have now turned a corner. In Bexley we have got GPs working on service redesign. When you get GPs back involved in service redesign, they are engaged.

'If we can get through authorisation smoothly, without too many conditions, and we get authorised, and get on with the job, I think we can get back to the optimistic stage. It depends on how the government want to play it. If the government want a light touch, it can work, if they insist on a heavy touch, they will kill it.’

NHSCB regional director of Midlands and the East, Dr Paul Watson, told the meeting: ‘The issue of bureaucracy, I agree we have to keep it to a minimum, but at the end of the day these are public bodies, they are statutory bodies, they work for you and me, they use our money. In the Midlands and East, we will be putting through about £20bn of public money through 61 CCGs and there has to be some proper governance around that.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Just published

BMA sign

BMA sets up first-ever ‘strike fund’ to support industrial action

The BMA is about to release £2m from its reserves to pay for possible ballots on...

Dozens of GPs with suicidal thoughts contact specialist service every month

A specialist mental health service for doctors is being contacted by dozens of GPs...

GP consultation

GPs demand this summer 'matched pre-pandemic winter'

General practice needs urgent support to cope with spiralling demand after appointments...

Talking General Practice

Podcast: Looking after GP mental health at a time of crisis

We speak to Dr Helen Garr, medical director of NHS Practitioner Health, about the...

RCGP chair Professor Martin Marshall (Photo: Pete Hill)

Government must take 'urgent action' on GP retention, says RCGP

GPs are being driven out of the profession by high levels of stress and burnout,...

GP surgery sign

GP workload far beyond pre-pandemic level as winter pressure looms

General practice delivered 26.5m appointments this August - 13.3% above the level...