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More centralised commissioning of specialist care ? Makes sense.
But for primary care it's an act of unmitigated idiocy and one of the stupidest ideas the White paper contains. Primary care is by its very essence a local issue, needing loccal voices and local solutions.
Quite tellingly, at the Pathfinder Conference in London last week, David Nicholson was asked a fairly straightforward question; if we're really seruious about shifting resources and services locally away from hospital-based care, then how excatly do we achieve that in practical, basic decision-making and investment steps ? Nicholson ducked the question. Indeed, the questuion has been consistently ducked. All we've had is endless rehearsals (and Sir david did the same last week) about the need to avoid conflicts of interst, and the necessity of appropriate organisational behaviours. No solid, practical, 'how do we get from A to B ? ' answers.

The GPs on my patch are asking it too. Repeatedly.And I can't give them an answer. If anyone can point me in the direction of anything that gives some answers, I'm all ears and eyes.