Election 2010: What is the Liberal Democrat vision for general practice?

Liberal Democrats: Shadow health secretary Norman Lamb sets out his plans to reform general practice.

Norman Lamb: bigger roles for GPs
Norman Lamb: bigger roles for GPs

Why do you want to do away with GP practice boundaries?
People should be able, within a sensible geographical area, to choose which GP practice they register with.

There may be good reasons why people prefer not to register with the practice nearest home. We should try to facilitate that if possible. In rural areas, neighbouring towns may each have a single GP practice.

If you do not feel comfortable with your local practice, you should be able to opt for another nearby.

There may have to be reciprocal arrangements in place for home visits. I would want to implement this only after discussion with the BMA.

What role should GPs play in commissioning?
GPs are uniquely placed to play a big part in commissioning. They know their patients and the local NHS better than anyone.

We would look to give GPs a bigger role. There have to be safeguards against potential conflicts of interest.

However, GPs tell me that they have become very frustrated by the impediments put in the way of commissioning - and providing additional services - by local PCTs.

Should NHS providers be 'preferred'?
No, it is vital that the only crit-eria for providers are quality of care and the value they bring to the NHS.

If charities, social enterprises or private companies have something innovative to offer, it would be foolish to sideline them for political reasons.

How will you attract GPs into commissioning or providing out-of-hours services?
We will ensure local GPs provide out-of-hours care. This doesn't mean that all day-time GPs will be forced to cover nights and weekends.

Commissioners should base contracts for out-of-hours care on local GPs providing care rather than doctors flown in from overseas.

If your party takes office, does the Doctors' and Dentists' Review Body have a future?
Yes, we believe it is vital that pay award recommendations are set independently. But the financial situation means for the next two years we would restrict pay rises in the public sector to £400.

Do small or single-handed GP practices have a future?
Yes, small and single-handed practices can provide excellent care, we have no intention of stopping this. RCGP work on federated practice models shows how small practices can be supported to overcome some problems they face.

How can you speed up the transfer of services from hospitals into the community?
We believe it is vital that more services are transferred to the community. Part of the process will involve engaging with the public to explain why this is happening and GPs and other clinicians need to play the leading role in this.

GPs and PCTs should work together to realise the potential for getting care closer to home.

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