King's Fund says competition is bigger threat to GPs not hospitals

GPs have more to fear than hospitals from opening up competition under the NHS reforms, according to the King's Fund.

Care of the elderly and chronic care management could be among services targeted by new providers (Photograph: SPL)
Care of the elderly and chronic care management could be among services targeted by new providers (Photograph: SPL)

Nick Goodwin, King's Fund senior fellow, said he did not expect most local hospitals to have to compete with new providers.

'There is more of a likelihood of new entrants into primary care markets taking away general practice opportunities,' he said.

There will be an opening up to a form of competition from outside companies, he said. These could include community interest-based companies or joint venture firms offering services such as chronic care management and care of the elderly.

These organisations will be 'delivering a new type of service,' and competition will be introduced into primary care, Mr Goodwin said.

It is also possible that these services will be taken on by private companies, he said.

GPC deputy chairman Dr Richard Vautrey said it was important that services did not become disjointed.

'The biggest worry is a fragmentation of services which used to be provided in a holistic way,' he said.

But Essex LMC chief executive Dr Brian Balmer said he doubted the viability of private firms entering primary care. 'There's not a lot of money in primary care,' he said.

Chief executive of Wessex LMC Dr Nigel Watson agreed.

'Private companies, such as Virgin and supermarkets, have tried it in the past but generally they can't do it cheaper,' he added.

Mr Goodwin said GPs would continue to be at the centre of primary care, but that they could offer a more personalised service by working with outside companies which 'co-ordinate care across the system and help patients with self care'.

He added that GPs need to start 'working collegially with other partners in care' in order to be able to provide a 'wrap around of services'.

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