Editorial: Keep White Paper bureaucracy to a minimum

Last week the first NHS Alliance/RCGP White Paper listening event took place in London.

There is nothing quite so enlightening as hearing at first hand from GPs about the opportunities and challenges that health secretary Andrew Lansley's vision creates.

Nine weeks after its publication, Liberating the NHS is still a document that begs more questions than it, and subsequent related DoH documentation, answers.

This week's GP newspaper explores fears that GPs could be shackled by a complex, bureaucratic framework to prove commissioning decisions are not undermined by conflicts of interests.

It's absolutely key for the White Paper because the innovative practices consortia will comprise are likely beneficiaries from the inevitable shift of work from secondary to primary care.

The audience at the listening event was so full of queries it would perhaps have been better described as a questioning event.

Examples included: how much will consortia be able to spend on management? How will the funding formula allocation for PCTs, and then consortia, change? What size should consortia be? All reasonable and fundamental questions for what speaker after speaker described as 'radical' change.

Where answers were given - consortia size should be chosen by GPs - they often didn't feel full and satisfactory.

Surely this is the conundrum now facing health secretary Andrew Lansley. GPs, or at least those contemplating leading consortia, are clamouring for more information to seize the initiative yet the coalition government apparently doesn't want to bog them down with too much bureaucracy.

The challenge for those at Richmond House is to provide these go-ahead GPs with enough of the answers that they need now to make a decent start, without miring them in so much red tape that they have no freedom to innovate.

Tune in after the consultation on the White Paper closes on 11 October to see how they do.

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