GPs ‘need help with NHS budget’

The NHS is under going a major revamp

MPs have heaped more pressure on the government for its overhaul of the NHS in England by suggesting GPs should not be allowed to take control of the budget all by themselves.

The House of Commons’ health committee said they should be joined by a range of staff including nurses and hospital doctors to decide how funds are spent.

The move would improve accountability and decision-making, the MPs said.

It came as ministers plan a new push to convince people of the need for change.

Criticism has been mounting in recent weeks that the reforms could lead to the privatisation of the NHS.

While the government has rejected these claims, there has been an acceptance in recent days that the government has not being doing well enough at communicating the need for change.

On Monday, Health Secretary Andrew Lansley said he wanted to use the coming weeks to engage with people. Details of a so-called “listening exercise” will be sent out later this week, but it is expected to involve both David Cameron and Nick Clegg.

Under the reforms, the government wants GPs working together in consortia to take control of much of the NHS budget so they can plan and buy local health services.

But the MPs said the sole focus on family doctors was wrong.

Instead, they said the GP consortia should be re-named NHS commissioning authorities and be overseen by a board with representatives from other specialities.

The MPs accepted GPs should still be in a majority but added by involving public health chiefs, hospital staff, nurses, councillors and social care officials it would become more accountable and effective.

Committee chairman Stephen Dorrell, a Tory MP and former health secretary, said such a move was not just a “minor tweak” as it would lead to the groups taking on even more responsibility for services such as dentistry that under the current plans would be organised by a national board.

He said the expertise of other professionals was essential to ensure the best decisions were taken and to avoid conflicts of interest.

“If you are going to design cancer services is it not a good idea to include cancer specialists?”

But he added the move would also help build consensus over the tough actions that would be needed to help the NHS save money in the coming years.

“An old rule of human nature is if you feel you are being involved you are more likely to accept consequences of a decision.”

The committee also said the plan to encourage greater competition – a key plank of the reform programme – risked undermining the decision-making process.

The MPs said there may be instances where commissioners may want to just use one provider – perhaps a local NHS hospital to keep an A&E unit viable – but that may not be possible if competition law was strictly applied.

Rosie Cooper, a Labour member of the committee, said it was time for the government to “take a deep breath” and have a re-think over its plans.

Nigel Edwards, acting head of the NHS Confederation, which represents managers, said the proposals had merit, but he warned against getting councillors involved in the commissioning groups.

“There are very few questions to which the answer is ‘more politicians’. We’re all for more scrutiny of GP consortia decisions but there is a point where political involvement becomes unhelpful to the running of an organisation.”

The Department of Health said it would consider the recommendations in due time.

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