Minister seeks to defend lack of GPs in CCG lead role
Health minister Lord Howe has attempted to defend the health reforms against HSJ’s finding that fewer than a quarter of clinical commissioning groups will have a GP as their accountable officer.
HSJ analysis last month found that just 22 per cent of all 211 CCGs would have a GP as their accountable officer. The role will be formally accountable for CCGs’ duties, functions, spending and governance. The government and NHS Commissioning Board have encouraged clinicians to take up the roles over the past two years.
The finding was raised in a debate on CCG governance in the Lords last month. Lord Howe responded in a letter to peers.
He says in the letter it is “a matter for the CCG to decide whether it wants to appoint a GP or not” and highlights that “the same Health Service Journal report quoted also stated that 89 per cent of GPs were fulfilling the role of CCG governing body chair”.
But the minister says: “It is important that there is a good mix of expertise with clinicians and managers in the broader leadership team to help a CCG discharge its responsibilities effectively.”
The issue was raised in the debate last month by Labour peer and former health minister Lord Warner.
He said HSJ’s figures showed “a situation in which GPs as a whole are walking away from a leadership role in commissioning”. He said: “That leaves the government’s strategy of increasing clinical involvement in commissioning, which I wholly support, in a very weakened state.
“It suggests… we will end up with more than 200 CCGs replacing 150 PCTs, but still with about 150 PCT chief executive equivalents running the show within CCGs.”
Meanwhile, the government has refused to reveal key details about the national assessment centre for potential CCG chairs and accountable officers. The centre was established by the commissioning board in the spring to assess whether individuals were suitable.
Labour MP for Sheffield Heeley Meg Munn asked in a parliamentary written question how many potential applicants the assessment center had considered for each role, how many were judged to be not eligible for appointment, and what assessment the commissioning board had made of applicants’ suitability.
The commissioning board is due to approve appointments as part of the CCG authorisation process, and has said it will use reports from the assessment centre to make judgements.
Health minister Anna Soubry said she would not answer the questions because the authorisation process had not been completed.
Ms Munn said: “This is further evidence of the shambles of the NHS re-organisation. The history of primary care trusts demonstrated that few clinicians wanted to take on managerial roles in commissioning.
“Instead of finding better ways to involve clinicians in decision making in PCTs, this government has spent a lot of scarce tax payers money only to find itself back where it started.”
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Readers' comments (12)
Anonymous | 16-Nov-2012 0:03 am
It never made sense to put GPs in charge of the executive function of CCGs. The shock is not that there are so few but so many GPs in the accountable officer role. What do GPs know about running multi-million pound commissioning organisations? There is a poll on the subject here: www.networks.nhs.uk
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Anonymous | 16-Nov-2012 9:07 am
Completely agree with anon 0.03am
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Anonymous | 16-Nov-2012 10:04 am
I agree with anon 0.03am too! There are many truly inspirational GPs in Chair roles working closely with these AOs and I suspect this is the sustainable model for the future. We'll see....
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Anonymous | 16-Nov-2012 12:56 pm
Would HSJ like to profile the CCG's who have a GP chair, their starting point, support in place, potential challenges and then monitor their progress? Comparison against the other 78% would be illuminating as well.
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Anonymous | 16-Nov-2012 2:02 pm
Be interesting to see whether the 22% sustains or reduces over time. I know where my money is
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Anonymous | 16-Nov-2012 2:19 pm
These comments show little understanding of the true strength now emerging when Clinical Chairs and Management AOs combine around a shared agenda. It is deeply annoying to hear these ill informed comments, which undermine the real difference being made in some areas.
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Anonymous | 16-Nov-2012 2:26 pm
What did most PCT chief execs know about running large commissioning organisations?
Many of the appointees seem to have been put there to do what the NCB tell them, in preparation for a revolution after the next election. I imagine that most GPs saw through this and didnt want to be puppets
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Dave West | 16-Nov-2012 3:37 pm
Hi Anon 12.56 - I will have a think about how we can do this.
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Anonymous | 16-Nov-2012 8:24 pm
Would HSJ like to profile the CCG's who have a GP chair, their starting point, support in place, potential challenges and then monitor their progress? Comparison against the other 78% would be illuminating as well.
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Stephen Kell | 17-Nov-2012 10:43 am
How many GP leaders have 'walked away'? It's a different issue from Chief Officer/Chair debate. Lots of GPs leading from role as Chair, recognising the valuable role of managers as chief officers. Titles not as important as outcomes and clinical chairs feel just as accountable.
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Anonymous | 18-Nov-2012 11:14 am
Would HSJ like to profile the CCG's who have a GP chair, their starting point, support in place, potential challenges and then monitor their progress? Comparison against the other 78% would be illuminating as well.
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Anonymous | 28-Nov-2012 1:11 pm
Would the HSJ like to look at the cost of employing a GP against what is paid to non-clinical leaders?
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