NHS Health Bill 'limits GP consortia control over spending'

The Health Bill will lead to GP consortia having less control over where patients are treated than PCTs have now, according to one of the RCGP's clinical commissioning champions.

Dr Fisher: 'In the new system, patients will be encouraged to go to anyone, anywhere'
Dr Fisher: 'In the new system, patients will be encouraged to go to anyone, anywhere'
Dr Brian Fisher, also on Lewisham PCT's professional executive committee, said encouraging patients to choose between providers at 'every stage' of their treatment mitigated the effect of designing specific care pathways.  

Enforcing the policies of ‘choice’ and ‘any willing provider’ on consortia mean they will not be able to send patients to the best provider, said Dr Fisher.

'Our PCT currently negotiates with a number of providers and tenders out so we can select a provider that meets our requirements. At least we know the vast majority of patients will go to the local hospital and we can monitor it for quality,’ he said.

‘In the new system the whole idea won't be to tender at all; patients will be encouraged to go to anyone, anywhere, who is accredited to provide that treatment.’

Monitor chairman David Bennett has said the regulator will allow consortia to ignore competition rules if this is in patients’ interests.

But from 2012, Monitor will ensure commissioners do not provide any barriers to alternative providers looking to treat NHS patients.

This month the NHS Cooperation and Competition panel (CCP) ruled that PCTs directing patients to certain providers could be breaching patients' right to choice.

Dr Fisher called for amendments to the Health Bill to allow consortia to use NHS hospitals as their preferred provider and turn to alternative providers only if they need to.

NHS Alliance chairman Dr Michael Dixon said the CCP ruling would have ‘enormous consequences’ on GPs’ ability to control expenditure.

‘If consortia redesign services to save money, this means they won’t be able to ensure patients are referred to the service,’ he said. The GPC recently accused the government of 'reneging' on its promise to empower GPs.

The committee feels Monitor and the NHS Commissioning Board will prevent consortia from exercising real freedom to manage budgets.

Dr Fisher said he hoped the NHS would be able to 'cobble together' a solution if no amendments were made to the Bill.

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