Editorial Tuesday 1 November 2011: Who is to commission primary care? Lansley says NHSCB; Nicholson says CCGs

I'm confused. (Regular readers will not find this statement to be a surprise.)

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Click here for details of 'A shadow no bigger than Comrade Sir David’s gripping fist - Lansley, Nicholson and Chairman Mal vie for supremacy', the new issue of subscription-based Health Policy Intelligence.

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Last week, Pulse reported Health Secretary, saviour and liberator Lansley as saying that the commissioning of primary care was staying firmly with the NHS Commissioning Board, despite previous comments from Dame Barbara Hakin and Professor Steve Field.

Today, GP reports that Comrade Sir David Nicholson told the NAPC conference that he wanted to see "innovative" ways of the NHSCB working with CCGs to give the latter power and control over primary care commissioning.

While the piece says that the NHSCB will hold GP contracts, GP reported Sir David as wanting to examine means of "embedding the activities of the NHSCB in CCGs. I think we need to do some experiments. It seems it is a very important lever for the clinical commissioning group working collectively to have more control over the commissioning of primary care".

General practice is not all of primary care, but it's one hell of a lot of it. The lack of clarity is a real concern. The destabilisation and uncertainty among PCT staff (oh, sorry, "bureaucrats") scarcely sets a wonderful example of how to do reorganisation effectively.

I've asked the DH media team for an explanation, which will follow here.