GPs recognise that commissioning will lead them to acquire a new set of skills never taught at medical school. While some will be an extension of existing skill sets, others will be new for them and their practices.
One of the bigger challenges is likely to be learning how to deal with being the target of political campaigns spearheaded by local MPs to 'save' services in local hospitals.
In May 2010, as health secretary Andew Lansley went around hospitals reopening previously closed wards and services, he made it clear that the only way he would agree reconfigurations of hospitals' services is if they were approved by local GPs.
Given the government's intention to give commissioning power to GPs, it makes sense to ensure that the configuration of hospital services fits in with GPs' clinical judgments.
This brings GPs into the centre of political campaigns about hospitals that are part of MPs' daily work. Called 'pressure group politics', finding out who makes decisions and launching campaigns at them is what GPs' local MPs do. It is all about 'How do I apply public pressure to make decision-makers make the judgments I want them to?'
MPs have already begun directing local campaigns at GPs, as the new decision-makers.
Waging a campaign
One of the first to have done this is housing minister Grant Shapps. He is leading a campaign to develop maternity care at the new Queen Elizabeth II (QE11) hospital in his Welwyn Hatfield constituency and, as a minister, he points the way for the future local politics of healthcare
Mr Shapps said in his local newspaper on 8 November: 'The battle is on to convince our GPs that babies should still be born in Welwyn Hatfield in future. As I have confirmed, we now have the chance to include a midwife-led birthing unit at the new QEII hospital.'
Urging every Welwyn Hatfield resident to join the campaign by writing to their GP and asking them to 'say yes to maternity' at the QEII, he said this 'important project' could only go ahead if GPs were in control of what is included within the new hospital.
The government claims to want to take politics out of the clinical decisions that shape the NHS. But even before the Health Bill reforming the NHS was published on 19 January, a government minister clearly wanted to introduce GPs to politics in a big way by trying to ensure their clinical judgments match his political ones.
Welcome to the new world of being the subject of pressure group politics.
- Paul Corrigan is a management consultant and former special adviser to Tony Blair. More at www.pauldcorrigan.com