As GPs, we hold a central place in the affordability of the NHS. That is to say the costs of the NHS are largely dependent upon our prescriptions, use of diagnostic tests and referrals, as well as our ability to provide extended care in the community and reduce unnecessary call on hospital services.
Practice-based commissioning (PBC) enables us to do these things and also provides us with a new role as health leaders in improving local health. Unfortunately, in too many areas, it has proved to be bureaucratic and GPs have felt disempowered.
The DoH and SHAs must now throw their full support behind PBC and encourage PCTs to fully support it too.
They must make sure that GPs feel valued, understood and respected. They must also involve and engage GPs in ongoing policy. Only then will GPs want to raise their game to a fuller NHS responsibility over and above the good of the patient in front of them.
Our current health system, with Payment by Results and strong foundation trusts, encourages hospitals to swallow up a disproportional amount of available resources and will, if left, bankrupt the NHS.
Changes to Payment by Results and a total commitment to PBC are now urgently required. The Commonwealth Fund has highlighted the enormous success and potential of British primary care.
It is time for the NHS to use it not abuse it.
Dr Michael Dixon, chairman, NHS Alliance
