The prospect of GPs blowing the NHS commissioning budget remains the prime concern of health secretary Andrew Lansley’s Westminster colleagues.

The Conservative chair of the Commons health committee gave a one word response to the size of the 2009-10 GP commissioner overspend: “Crikey”.

Now isn’t the time to be experimenting with large sums of money

Stephen Dorrell said the 2.5 per cent net overspend was even more worrying considering it was created “in a year when the NHS budget was growing”.

He said HSJ’s analysis highlighted the need for GP consortia to develop “effective means for dealing with overspends” so that “the Treasury, the taxpayer and the rest of the health service can be reassured the NHS can live within its means”.

He said he would be opposed to using the kind of topslicing mechanism strategic health authorities have previously used to control primary care trust spending, as those often meant resources were unjustly reallocated to overspenders.

Instead he said financial controls needed to boil down to “saying ‘no’ to things you would like to do” - a pressure which needed to be exerted by the structures of each GP consortium itself, if necessary by “transferring” functions and processes already developed by PCTs.

Outside of the Conservative party, politicians are more direct in voicing their concerns.

Liberal Democrat committee on health co-chair John Pugh told HSJ he was hoping to generate what he called a “rational debate” at his party’s conference next month on the white paper and the risk of GPs overspending the NHS commissioning budget.

He said the urgency for this debate was heightened by HSJ’s finding on the state of the 2009-10 overspends.

Mr Pugh, who is MP for Stockport, said: “This chimes in with some of the concerns voiced by the Treasury. Now isn’t the time to be experimenting with large sums of money.

He said GP commissioning was “a high risk strategy, particularly when public funds are constrained. Last time the NHS was overspent it was the SHAs that brought it back into line and they won’t be there to do that this time”.

He told HSJ many of his party colleagues had also been disappointed by the white paper’s abolition of PCTs, as the Liberal Democrats had been keen to see more joint working between coterminous PCTs and councils on health and social care.

He said: “Andrew Lansley is clearly a guy who does work very hard at his portfolio. But how flexible he is and how much he will listen to evidence, I don’t know.”

The accountability of overspending GPs