Tories would scupper plans for ICOs, promises Lansley

NAPC Conference 2008 Integrated care organisations - Darzi review failures - NHS surplus - GP profits.

A Conservative government would block development of integrated care organisations (ICOs), Andrew Lansley has said.

Speaking to the National Association of Primary Care's (NAPC's) autumn conference in Liverpool last week, the shadow health secretary said he wanted to 'pour cold water on the idea' of ICOs.

'I don't think we need a new organisation,' he said. 'Integrated care, in my view, should be the central task of primary care commissioners.'

Those ICOs that already exist would be restricted to a commissioning role, he said, telling the director of one such organisation that he would block its plans to expand from commissioning into provision.

'I will insist the two roles must be clearly separated,' he said. 'We are approaching the 20th anniversary of the commissioner-provider split, and we have still not done it properly.'

He added that London's University College Hospital's plan to open its own polyclinic, which has now been abandoned, would have been 'unacceptable'.

Dr James Kingsland, president of the NAPC, said there was much to commend in Mr Lansley's speech, including his focus on practice-based commissioning (PBC) and his commitment to give real budgets to GPs.

But he questioned Mr Lansley's criticisms of ICOs. 'By their very nature, like general practices, they have to be both commissioners and providers,' he said.

'In a list-based system there is no conflict of interest there.'

Mr Lansley also said that, despite the party's decision to break with Labour's spending plans, the Tories were committed to continuing real terms growth of the NHS budget.

He repeated the party's pledges to transfer commissioning budgets from PCTs to GPs, to create incentives to engage in PBC and to save and re-invest money.

'The PCT has to change the way that it does its job,' he said.

NHS chief executive David Nicholson made similar comments in his own speech, in which he admitted that some trusts still saw PBC as 'something PCTs give GPs to do'.

'We still need to shift the power relationship, by giving much more information and data to GPs,' he added.

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