Gearing up for competition and building the barricades: GPs 'awkward position' - Health Policy Today, Monday 1st September 2008
August - the media's traditional 'silly season' - has been short on stories about GPs and polyclinics. Most of the month has been dominated by discussion of NICE and access to drugs, with the politics of food making an interesting appearance at the end of the month.
In September, these themes will continue and be joined by primary care finance and reform.
ANDREW LANSLEY CALLS FOR GP-LED REFORM
Today's Healthcare Republic reports an interview with Andrew Lansley has given to GP magazine. Lansley is supportive of reform, but is also positioning his party as champions of GP-led innovation.
Lansley praised the development of new social enterprise companies formed by GPs coming together to provide care in new ways. The example he gave was Devon Doctors, which is co-owned by 176 practices and provides out-of-hours care not only in Devon, but also in far away Halton, Cheshire. It has won contracts from the two PCTs to deliver care.
Lansley sees potential in transferring the innovation already shown, in areas like out of hours care and transfer this to more lataral thinking in service provision. Healthcare Republic say, 'Mr Lansley is keen for GPs to lead on commissioning and to think more laterally.
He is critical of PCTs that currently issue separate contracts for out-of-hours, accident and emergency, extended hours and ambulances. Entrepreneurial GP spirit could be tapped, he said, by allowing GPs to tender for this work across these areas.'
Lansley's words contrast with Labour's approach to reform - their rhetoric portrays GPs as an obstacle to reform. That said, both parties see promise in the efforts of entreuprenerial GPs. Looking at policies and political statements, however, the Conservatives give the impression that they believe this group to be larger in number than do Labour.
GPs GEARING UP TO TAKE ON POLYCLINICS
Labour's portrayal of the BMA (General Practice Committee - GPC) as a laggard does not sit easily with reports that its constituents (Local Medical Councils) are involved in a number of bids to manage and run new polyclinics.
According to a Pulse report last week, around a fifth of LMCs are involved in putting together bids. As the paper has it, 'GP leaders are setting aside their opposition to APMS and are taking on the private sector head-to-head'. Pulse says that the move puts GPs in 'an awkward position', coming barely a year after the GP body voted to actively oppose the scheme.
Giving us a glimpse of the motivation behind the change of heart, GPC head, Laurance Buckman is quoted as saying that he would join together with local GPs in order to prevent the private sector taking over.
'Even if the GPs are motivated by blocking the private sector, the excercise of bidding will force them to be clear about their plans for service development and places them as players in the reform, achieving the kind of clinical engagement that the government has said it wants to achieve'
As covered here a couple of weeks ago, GPC is about to launch the second part of its Save Our Surgeries campaign. It will focus on involving local authorities' Oversight & Scrutiny Committees (OSCs) in local decisions, including the award of a polyclinic to the private sector. This may create an environment which makes it politically expedient to support local GP bids.
The question is, will GPs compete with each other to win contracts? It is not clear at present, though there maybe bids from local GPs, together, against bids from GPs working in partnership with the private sector. Pulse reports an LMC leader (who wished to be nameless) saying he plans to go into partnership with the private sector.
Even if the GPs are motivated by blocking the private sector, the excercise of bidding will force them to be clear about their plans for service development and places them as players in the reform, achieving the kind of clinical engagement that the government has said it wants to achieve.