GPs have to make savings or inherit PCT debt

GPs must make savings for their PCTs this year to avoid inheriting debts, the NHS chief executive has told MPs.

Andrew Lansley: commisssioners face scrutiny under competition law (Photograph: JH Lancy)
Andrew Lansley: commisssioners face scrutiny under competition law (Photograph: JH Lancy)

The Health and Social Care Bill committee heard evidence from top NHS figures last week as it considers amendments to the Bill.

Sir David Nicholson admitted he cannot guarantee consortia will not inherit PCT debts. He told MPs it was 'his aspiration'

to ensure PCTs were in good financial health when they handed their powers to GP consortia in 2013.

But he said if GP consortia fail to engage with the DoH's money-saving QIPP programme (Quality, Innovation, Productivity and Prevention) then 'they won't have budgets to receive in 2013 because we will have spent all the money'.

Health secretary Andrew Lansley, in his evidence to the committee, said if GPs buy 'services from themselves' it will be considered 'an abuse' of new competition rules.

The statement appears to contradict DoH advisers who have warned that consortia must be able to commission enhanced services.

A DoH spokeswoman confirmed the commissioning of enhanced services will be scrutinised for anti-competitive behaviour, 'except where otherwise directed by the NHS Commissioning Board or secretary of state'.

RGCP chairwoman Dr Clare Gerada said the reforms could lead to consortia refusing to take on the most costly patients. She said that when practice boundaries are abolished, GP consortia would no longer be responsible for a clear population.

'Patients will be able to register with any consortium regardless of where they live. That will bring in all sorts of issues.

'There will be choice of consortia for patients. But there will also be consortia able to choose patients. If Mrs Jones comes to me with chronic renal failure ... there may well be no one that can mandate me to take on this high-cost patient.'

She called for legislation in the Bill to be clarified to ensure such issues were resolved.

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