GPs fear ‘outsourcing’ of commissioning

Commissioning support will be a defacto outsourced service by 2016, one of the leaders of the BMA’s GP committee has warned.

Dr Chaand Nagpaul, a negotiator for the BMA’s General Practitioner Committee, told this week’s National Local Medical Committee conference in Liverpool that the government’s plans for commissioning support in the new NHS would increase the role of private companies in the commissioning of care.

Dr Nagpaul said: “These are organisations that don’t have the loyalty, the accountability or the interests of the NHS at heart and so I think we should be concerned.”

More than 300 LMC representatives at the conference supported a motion voicing concern about the potential larger role for private companies in commissioning and also supported calls for commissioning support to be NHS-led and retained in-house by CCGs wherever possible.

Dr George Rae, secretary of Newcastle and North Tyneside LMC, claimed there were many examples of external support being “foisted” on CCGs with the pressure to sign up under the threat of not being authorised.

He added: “We have got to empower CCGs not to be railroaded into agreeing inappropriate arrangements which will not be in the best interests of patients or indeed GPs and certainly will not be locally responsive to the planning of services.”

However, Dr Jane Lothian, secretary of Northumberland LMC, told representatives that her LMC did not believe the introduction of private companies should be labelled as a threat.

She added: “Do we really want to continue with at best variable standards of business behaviour, email black holes, ever changing goalposts; the list is endless. This is an opportunity to establish robust transparent contractual mechanisms to control the commissioning process.”

The LMCs’ conference also criticised “new layers of bureaucracy” which it said would limit the freedom of commissioners and said GPs’ initial impressions of clinical commissioning had been changed by the reality of the Health and Social Care Act.

In a separate motion, GP representatives supported a motion from Cumbria LMC applauding the achievements obtained by GPs in reconfiguring local services and reducing secondary care activity when given delegated commissioning authority from a primary care organisation.

Dr Peter Weeks from Cumbria LMC told representatives that after five years of GP involvement in commissioning his area had see a 10% reduction in emergency admissions, GPs delivering the most cost effective prescribing in the north east and commissioners working with a recurring balance on their budget.