The Bill returns to the Commons today. Labour MPs have tabled an emergency motion in a last-ditch bid to halt it, arguing that it should not become law until the DH releases a ‘risk register’ detailing potential negative consequences of the reforms.
But the Bill looks set to receive Royal Assent imminently, formalising the removal of strategic health authorities and PCTs, and creating clinical commissioning groups (CCGs) and the NHS Commissioning Board.
GPonline.com looks at how key organisations representing GPs are reacting to the prospect of the Bill becoming law.
GPC chairman Dr Laurence Buckman said initial optimism about the reforms had been eclipsed. ‘The real shame about this Bill is that the potential for GPs to really shape and improve services was there at the beginning, but it’s everything else around that, particularly the focus on increasing competition, that is the problem.
‘We’ve already seen the freedom that CCGs were promised curtailed and budget restrictions which will mean CCGs will have to form into extremely large, probably quite remote organisations, ironically a bit like PCTs.
‘I’m very concerned about what buying in commissioning support will mean for CCGs and how much control these support services will end up exerting. If they’re run by the private sector we could end up with the de-facto privatisation of commissioning support.
‘The other area that really concerns me is the relationship I will have with my patients if they start to blame me and other GPs for any potential rationing of care, which due to the financial situation will inevitably have to take place. The really sad thing is that we could have had clinically led commissioning without this legislation and without all this costly and chaotic upheaval.’
RCGP chairwoman Dr Clare Gerada said: ‘We are of course disappointed that despite our concerns the Bill has gone through in this form and will now become law. As a professional group GPs have endured many reorganisations and still made services work for patients and we will continue to do so with these reforms.
‘The college has made its opposition to the Bill well known, but we have also been very clear on the distinction between the Bill in isolation, and the importance of the role of GPs in the planning and delivery of local services. Now that this Bill is set to become law we will support GPs in using their existing skills to ensure patients continue to receive excellent care.
‘GPs are adaptable to change, and will roll their sleeves up and get the job done no matter what, but we have a lot of hard work ahead of us to ensure that we continue to provide the best possible quality health service, for the professionals who work within it, and the patients who use it.’
National Association of Primary Care (NAPC)
NAPC chairman Dr Charles Alessi said: ‘The passage of the Health Bill marks an important point in the reform of our health service. What we now need to do is put our differences aside and concentrate on getting the best possible solutions for our patients.
‘We are in a good place to do so as we now have the liberties to manage our population in a way more consistent with their local needs and the CCGs will have the autonomy to manage this better than they had in the past.’
Family Doctor Association (FDA)
FDA chairman Dr Peter Swinyard said: ‘What it means for GPs in the future is a greater feeling of control over what services their patients can receive and the chance to innovate to do the things which in some circumstances we have been trying to do for years, but which have become mired in bureaucracy.
‘GPs have specialised in things like minor surgery for years, but these things are suppressed in the present system.
‘The biggest risk I see is the behaviour of the NHS Commissioning Board (NCB). It becomes a very powerful organisation, with the power of life and death over GP practices. I will be fascinated to see what is written into the regulations that follow the Bill.
'Another risk is that local outposts of the NCB may be run by dyed-in-the-wool old PCT people who don’t want to give up power. Another risk is the lack of money in the system - CCGs will have to decommission certain services, and it is very difficult for doctors to remove services from patients. Smart CCGs will have to engage with their communities, and if they decommission, it must be a community decision.’