NHS commissioning is an ethical duty for GPs

GPs have an ethical obligation to lead NHS commissioning, according to a close vote in a debate at the RCGP conference on Thursday.

Dr Gillies (left) and Professor Marshall debated the ethical stance (Photograph: Peter Hill)
Dr Gillies (left) and Professor Marshall debated the ethical stance (Photograph: Peter Hill)

South London GP Professor Martin Marshall, RCGP ethics committee chairman, argued that GPs did have an ethical obligation.

Professor Marshall, who is also clinical director and director of research and development at The Health Foundation, said commissioning would better enable GPs to coordinate the care of patients who were ‘lost in the system’.

He added: ‘Unless we take this opportunity it will be our patients who suffer.’

Dr John Gillies, RCGP Scotland chairman, opposed him. He said: ‘Rationing and commissioning are the same things. A legal obligation doesn’t mean we have an ethical obligation to do this.’

A wide-ranging debate featuring many audience contributions included former health minister Baroness Julia Cumberlege who has been debating the Health Bill in the Lords.

Backing commissioning, she said: ‘Patients trust GPs. If decisions are to be made on my care I really want to have very strong clinical engagement at the
very top.

‘I think that’s the way to get much better decisions.’

A West Midlands GP, who also chairs his local clinical commissioning group, said GPs were better placed to make difficult clinical decisions if finances were tight. ‘We have to be more answerable to patients than we ever have been before. This gives us the opportunity to do that.’

Speaking against commissioning, north London GP Dr John Salinsky said: ‘Imagine you are a prisoner of war and the camp commandant says as a doctor you must make the decisions about who should be fed.

‘Doctors may think they have an ethical obligation to do their best or they may think they have an ethical obligation to refuse and instead concentrate on trying to escape.’

Delegates were also asked to vote on the Health Bill and almost everyone who took part in the session thought it should be rejected.

GP Online recommends

GP Commissioning resource

Read more

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Close up of hand holding sample tube with 'Omicron' handwritten on side

Government urged to 'free up' GP practices and expand steps to control Omicron

GPs have called for immediate action such as suspension of QOF to allow practices...

(Photo: Mike Kemp/Getty Images)

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

External wall of GP surgery with wording 'medical centre'

‘Utterly toxic’: GPs speak out over abuse and physical attacks on practice teams

GPs have condemned a rise in verbal and physical attacks on practice staff - warning...

Artist's image of a spiked virus

Javid warns of 'substantial risk' from new COVID-19 variant

The highly mutated COVID-19 variant B.1.1.529 'may pose a significant risk to public...

Desk with lettering 'LMC conference'

LMCs reject 'outdated' GMS contract and demand move to item of service payments

LMCs have voted to scrap the 'outdated and inadequate' GMS contract and to replace...

GPs at an LMC conference waving green voting cards in the air

LMCs demand ringfence on enhanced services cash and clear GP representation in ICSs

LMCs have called for a ringfence on enhanced services funding, along with a guarantee...