PCT numbers to be reduced, King's Fund warns

PCTs are likely to be reduced in number and have fewer staff as GPs are given the 'onerous' task of reforming local services, according to King's Fund chief executive Professor Chris Ham.

Prof Ham: commissioning will be ‘really hard to get right'
Prof Ham: commissioning will be ‘really hard to get right'

Professor Ham, speaking at the annual conference of LMCs in London on Thursday, predicted that the new government would also ‘very much want to promote competition and choice in general practice'.

Despite the change of government, the profession is still likely to have to move towards federation of practices working in polysystems, he told delegates. 

‘An ageing population with more complex health needs requires further integration between GPs, hospital specialists and social care. To do that requires a different platform. It requires networks or federations of practices, retaining independence but committed to collaborating with each other,' said Professor Ham. 

The King's Fund chief executive was invited to explain how polysystems, choice between GP practices and GP commissioning might develop in the future.

Commissioning will be ‘really hard to get right', Professor Ham warned. ‘There will be a huge onus on general practice to do the heavy lifting when it comes to driving NHS reform.'

Delegates however remained confused and unimpressed by the conflicting policies. 

Dr Ian Keith, from Hampshire LMC, said: ‘I understand competition between providers, and collaboration between commissioners. ­­­­­ But soon we will be both providers and commissioners. Are we collaborating or competing?'

Dr Peter Gledhill, vice-chairman of Bedfordshire LMC, said: ‘This is all clearly very different from what we do now, but not demonstrably better. Which bit of what we do currently is broken?'

The conference went on to pass motions demanding there is evidence for polysystems before any more are developed. Motions were also passed to say delegates believe polysystems will destabilise general practice and could cause job losses.

GPC negotiator Dr Chaand Nagpaul said it was ‘a very serious motion'. ‘Polysystems don't even exist, they are a theoretical, ideological concept. They have been politically driven and NHS London, for example, was prepared to gamble millions of its scarce budget on what is basically an experiment.'

Click here for all the latest news from the LMCs Conference 2010

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