DoH should extend consortia powers

The DoH should have gone further with its NHS reforms and given GPs more power, according to the acting chief executive of the NHS Confederation.

Nigel Edwards: 'A trick was missed in not giving GPs more power'

Nigel Edwards was speaking at the fourth session of a House of Commons health select committee inquiry into commissioning last month.

'I think a trick was missed in the White Paper in not giving GPs more power,' he told MPs.

In time, he predicted, consortia would be handed powers to manage the GMS contract.

GP consortia's ability directly to influence general practice would be as important as influencing secondary care, he explained.

Speaking afterwards to GP, Mr Edwards said the additional powers would include GP consortia being the delegated authority to manage GMS contracts.

'The principle should be that, if you want to improve the system, why only have the tools to improve part of it?' he said.

Mr Edwards said that while peer influence was likely to be an important factor in the success of GP consortia, the White Paper should have gone further.

'If GPs are taking responsibility for the way healthcare is planned and managed across their system, it seems peculiar to leave out the one bit that has the most potential for change and improvement,' he said.

GP consortia taking the power for their locality would be more effective than a national NHS board.

Even if an independent board had 10 regional offices, it would be managing a population the size of Denmark. 'That's hardly local,' said Mr Edwards.

Mr Edwards predicted that sooner or later, GP consortia would be given power to manage GP contracts. He said more advanced consortia were in a position to take control now.

But he admitted there would need to be safeguarding measures to ensure there was no conflict of interest.

'That would be quite a simple mechanism,' said Mr Edwards.

He suggested that the national NHS board could act as an independent adjudicator in cases of dispute.

However, the GPC has said it is not in favour of consortia holding GP contracts.

The NHS Alliance has agreed, but the National Association of Primary Care backs plans to hand practices control of GMS.

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