Editorial: New government must not make old mistakes

The UK has a new government and GPs can expect significant change.

Health secretary Andrew Lansley has already announced that GPs are to take on responsibility for commissioning out-of-hours care.

This is an issue that divides the profession. Many GPs say they could do a better job commissioning out-of-hours services than their PCT, and it would mean patients no longer blamed GPs for the quality of a service over which they have no control.

Others fear that this is the thin end of the wedge and it is just a matter of time before the new government is forcing all manner of extra work on them, with no more resources (no change from Labour, many will say).

Funding will clearly be the key to making this work. The GPC has said it will not oppose responsibility for commissioning out-of-hours being added to the contract, so it seems likely that funding and resources will dominate negotiations.

More concerning than Mr Lansley's plans for out-of-hours is his policy for all GPs to hold budgets and commission local services. If the GMS contract is to be changed to include out-of-hours, then changes to force through budget holding could follow swiftly behind.

Mr Lansley may find the GPC less amenable on this point - it has already said it is against any attempt to make it compulsory for GPs to hold real commissioning budgets.

Of course, these proposals are not necessarily bad news for the profession. Providing GPs receive the resources they need, greater commissioning powers could deliver many opportunities to improve services, give GPs greater influence and put the profession right at the heart of the NHS.

However, these changes must not be forced onto GPs. It is vital that Mr Lansley and his ministerial team work in partnership with the profession and take the time to properly understand the impact of any new initiative.

The previous government alienated the profession by its failure to work collaboratively and its fondness for pushing through change without consultation. Mr Lansley must not make the same mistakes.

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