Exclusive - Tories will draw up new GP contract

Lansley says contract will put commissioning responsibility 'in hands of GPs'.

Andrew Lansley: If GPs have a deficit on their budget, it does not come out of their practice's income

Shadow health secretary Andrew Lansley has confirmed there will be a new GP contract if the Conservatives take office.

After his speech to the NHS Alliance conference in Manchester last week, Mr Lansley told GP that in order to put commissioning responsibility in the hands of GPs: 'We would need a new contract. And legislation, too.'

A Conservative spokesman confirmed the UK-wide contract would be split up, as the commissioning policy would be enforced in England only.

Mr Lansley insisted the 'real budgets' that GPs will be handed to buy and organise health services locally will be kept separate from practice income: 'If (GPs) have a deficit on their budget it does not come out of their practice's income.'

However, a Conservative spokesman later made clear that GPs who persistently fail to balance the books could lose their contracts.

Mr Lansley also confirmed that GPs will be able to let GP consortia or private firms commission on their behalf.

Following 'considerable discussions' with the GPC, the Conservatives are now working on the best way to use data to allocate commissioning budgets to GPs.

The shadow health secretary added that the outcomes-focused QOF that the Conservatives plan to develop should mean that GPs' efforts to redesign services are rewarded as public health improves.

GPC chairman Dr Laurence Buckman said he would discuss funding plans for GP commissioning in detail only if the Conservatives are elected next year.

But his main concern was how GP income is kept separate from commissioning performance. He suggested GPs may be put off commissioning if their basic income was under threat.

'What happens if the money runs out?' he added. 'What happens to GPs who are not trained or not very good at managing budgets?'

Dr Buckman was also concerned about GPs being able to hand commissioning responsibility to private companies. 'Consortia are not a worry, private companies are. That will allow the private sector to get into all sorts of things, such as commissioning services from themselves.'

Meanwhile, BMA chairman Dr Hamish Meldrum appeared to reject Conservative plans for GP commissioning at a health select committee evidence session last week.

Calling for a collaborative approach to commissioning, Dr Meldrum argued that handing one section of the NHS full control of budgets was a 'crude' method of bringing people to the table. He said this should only be necessary where relationships between NHS organisations were poor.

However, a poll of delegates at the NHS Alliance conference, which included a range of clinicians, managers and others, found 53 per cent of delegates believed GPs should be handed 24-hour responsibility for commissioning care for patients.

Tory contract plans
  • New contract to hand GPs in England responsibility for commissioning.
  • GPs can outsource this commissioning role to firms or other providers.
  • Commissioning budget and practice income 'remain separate'.
  • But poor commissioning could put contract at risk.

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