Health secretary Andrew Lansley has taken the BMA to task over
its opposition to his ‘any willing provider’ policy, and made it clear
that the Government has no intention of reversing its drive to
stimulate competition in the NHS. In an exclusive interview with
Pulse, the health secretary argued the policy would not only drive
innovation, but act as a vital tool for tackling conflicts of interest
among GP commissioners. GPs, he said, would be prevented from simply
referring to services in which they held a financial stake by the need
to offer patients a full choice. Mr Lansley also disclosed that
Payment by Results tariffs would be extended to primary care by 2013,
to ensure GPs couldn’t make excessive profits from services they
provided by making them work to a set price. Mr Lansley delivered a
stern riposte to the BMA after the association outlined its ‘profound
opposition’ to his plans to increase NHS competition, and warned they
risked pitting GP commissioners against providers and fragmenting
patient care. The health secretary has made great play of his
willingness to listen, but on this point he was bullish – accusing
doctors’ leaders of attempting to block innovation in the NHS and
insisting he had no intention of changing tack. ‘The BMA and some
others take a view that they do not agree with an any willing provider
approach,’ he told Pulse. ‘They want to hark back to the idea there
are somehow bodies within the NHS and everybody else isn’t. We had a
mandate to move to an any willing provider approach – it was in our
manifesto and the Lib Dems'.’ Mr Lansley said the requirement to offer
a choice of provider would be crucial in tackling accusations of
conflict of interest in GP commissioning groups, highlighted recently
by a Pulse investigation showing as many as one GP in four has an
investment in a local private provider of NHS services. ‘When GPs do
that referral, part of the contractual obligation will be to provide
patients with choice. So they have to offer the choice and demonstrate
they’ve offered choice,’ he said. Shadow consortia would get some, but
less than half, of their management allowance in 2011/ 12, and in many
cases control of ‘the great majority of the management resources’ in
2012/ 13, he said. The health secretary added that there would be a
major trimming of the functions currently done by PCTs, with some
scrapped altogether, and GP consortia only taking responsibilities
specifically relating to commissioning care for patients. He said:
‘Some of the apprehension has been when people have looked at
everything a PCT does and assumed they will have to do all those
things. Of course they won’t.’ But one responsibility that will be
heading GPs’ way is for the overall commissioning budget, including
any debt hanging over from the previous regime.
GPs the future
Summary:
Lansley's interview with Pulse Nov 2010
