HSJ’s roundup of Friday’s must read health stories and debate

A radical proposal

While many NHS eyes have been looking ahead to the spending review on 25 November, there is important parliamentary business to consider before then.

MPs will consider plans to give ministers wide ranging new powers to transfer NHS functions, funding and assets to councils next Tuesday.

This comes despite experts telling HSJ the Cities and Local Government Devolution Bill could lead to significant variations in the service offered in different parts of England.

The bill includes a clause specifically about the NHS, which if enacted would enable ministers to transfer NHS functions to ”combined authorities” made up of two or more councils or “other public bodies”.

At its most extreme, all responsibilities of a CCG could be taken on by a combined authority.

Mark Dayan, policy and public affairs analyst at the Nuffield Trust, warns on hsj.co.uk that while the NHS’s financial doom may makeconstitutional tinkering seem almost frivolous”, managers and clinicians must “prepare to take centre stage in devolution”.

He says that once the bill passes, “the NHS will feel very different, even in areas pursuing more limited models of devolution, based on health and wellbeing boards or delegation of NHS powers”.

“Managers and clinical leaders need to make their voices heard through the long process of devolution ahead. And they need to prepare for a less ‘national’ health service than ever before.”

Meanwhile, HSJ has learnt of a number of organisations in the capital have set out their devolution bids, covering north east London, north central London and Hackney.

’They can’t sack us all’

A former British Medical Association negotiator has called for GPs to “revolt” if the Care Quality Commission implements a proposed sevenfold increase in fees.

Peter Holden, a former negotiator for the BMA GPs committee, who still sits on the committee and the BMA council, said he had contacted fellow doctors urging them to pay “this year’s fees plus 1 per cent”.

He continued: “Technically it’s illegal for me to propose it on several fronts. But actually what are they going to do? They can’t sack us all.”

The CQC is currently consulting on its fees for the next few years, and we won’t know how much services will have to pay until next year. The Department of Health has also tried to smooth things over by pledging £15m to ameliorate the impact of any rise on GPs.

However, Dr Holden’s threat of “civil disobedience” is a sign that genuine anger towards the CQC is brewing in the GP community.