GPC open to talks on out-of-hours

The GPC will not oppose Conservative plans to give the commissioning of out-of-hours and other NHS services to GPs.

Andrew Lansley arriving at Downing Street before being named health secretary in the new government (Photograph: Getty Images)
Andrew Lansley arriving at Downing Street before being named health secretary in the new government (Photograph: Getty Images)

GPC chairman Dr Laurence Buckman said he was 'open to talks' after assurances from health secretary Andrew Lansley that the bulk of the GMS contract was safe.

Meanwhile, as health policy takes shape under the coalition government, a Tory adviser suggested the Care Quality Commission (CQC) may be targeted in a bureaucracy and cost-cutting exercise.

Under current plans, practices will be forced to pay an annual fee to register with the CQC from April 2011.

Shifting the QOF to focus on outcomes by scrapping 'unnecessary' registers is likely to be a GP contract negotiating priority, Tory advisers say.

Dr Buckman said that giving GPs responsibility for commissioning would be 'positive' for GPs and patients.

'We are open to talks. We don't know what it means, and I'm not sure (Mr Lansley) knows, until we get a more refined idea of what GP commissioning might look like,' he said. 'But we are not against the idea.'

Dr Buckman said he received an unsolicited call from the new health secretary after newspaper reports last week suggested Mr Lansley planned to 'tear up' the GP contract and force GPs to work out of hours.

'We've had lots of conversations about GMS but they have made no specific suggestions.

'The only thing they have done is to call me and warn me that there will not be wholesale renegotiation. Which is a good sign that they want to make sure I know what is happening,' Dr Buckman said.

Dr Paul Charlson, a member of the Conservative party clinical advisory committee, said he expects commissioning responsibility to be 'more of a voluntary thing' initially.

'The idea is to encourage as many to do it as possible but we recognise some just won't want to do it. If you can't get anyone to do it in the local area then it goes back to the PCT,' he said.

Dr Nigel Watson, chairman of the GPC commissioning and service development subcommittee, said the Tory plans 'still lack detail' but there was support for more commissioning responsibility among GPs.

UK LMCs conferences have narrowly backed motions calling for GPs to take on commissioning of out-of-hours.

'There is an appetite to do something where it's clinically led and locally driven, and if there is genuine change away from red tape and bureaucracy,' Dr Watson said.

He warned however, that GP commissioning in certain areas was more advanced and 'would move faster' than in others.

Dr Charlson said Tory advisers were 'doing as much as we can' to get outcome measures into the QOF and remove 'unnecessary registers'. He also said the cost-effectiveness of NICE and the CQC would be 'examined'.

'The CQC is quite a bureaucratic organisation and there is an emphasis on bureaucracy rather than monitoring. There is a large fear that when it starts to regulate GPs it will create a lot of work and cost.'

Mr Lansley has pledged that there will be no service or hospital closures where there is opposition from local clinicians. But he also warned that the NHS may need to find more efficiency savings over the next three years than the £20 billion Labour estimated was needed.

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