Mr Lansley told the RCGP’s annual conference that funding issues would be handled by consortia to protect the doctor-patient relationship.
But he warned of an ‘unprecedented squeeze’ on funding, that existing PCT contracts would have to be honoured, and that failing consortia would be ‘disbanded’.
Mr Lansley told the conference in Harrogate: ‘It would be unacceptable for the rationing of limited resources to take place at the level of the GP and their patient. That’s not what I mean by commissioning.
‘Commissioning is about ensuring the services you need are available and the choices are there. Where investment or disinvestment are needed there will be collective decisions in conjunction with healthcare providers and local authorities. It is not a decision for individual GPs to make.’
GPC chairman Dr Laurence Buckman welcomed the statement: ‘We've been encouraging the secretary of state to think like that.’ Dr Buckman said GPs could collectively be involved in spending decisions but individually treat patients as their first priority.
RCGP chairman Professor Steve Field said it was ‘great to hear a politician speak our lanuage of patient-centredness’.
In a question-and-answer session after the speech, south London GP Dr Eugenia Lee asked the health secretary what would happen to a consortium that failed. He said consortia would be guided and protected, and given access to national and local risk pooling arrangements.
‘But in the long run if a consortium fails and cannot meet its obligations, on either quality or finance, there will be a process by which it will be disbanded and a new consortium established with new managerial responsibilities.
‘But that does not change the direct relationship through the contract with the individual practices. That’s still governed by the GP contract.’
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