Hint at debt free start for commissioning consortia

Health minister Earl Howe told delegates at the NHS Alliance conference last Friday: “Let me reassure you we are working with SHAs to straighten this out.”

He said more details would be available in the operating framework next month.

DH national quality, innovation, productivity and prevention lead Jim Easton responded to questions on the issue at the event by saying: “The wind is now moving in your direction in terms of a good starting point [for GP consortia].”

But he said GPs should not act as if they were blameless in the creation of large PCT deficits. At the end of 2009-10 four PCTs had deficits totalling £39m, with individual shortfalls between 0.4 per cent and 4.7 per cent of their budget.

GPs have been lobbying the DH for a commitment that consortia will not inherit PCT debt but the PCT Network said this would remove an incentive for GPs to help control spending.

Network director David Stout said: “They should inherit these budgets. GPs should get involved now to make sure decisions are made effectively.”

However, the new chair of the Royal College of GPs, Clare Gerada, has raised concerns over potential conflicts of interest between GPs’ new role as commissioners and their existing one as providers of primary care.

Speaking at a Cambridge Health Network event Dr Gerada said a blurring of the boundaries between commissioning and the provision of primary care services was “inherently unsafe”.

“Decisions about resources should be made as far away as possible from decisions about provision made in GP surgeries,” she said.

She said there would be potential conflicts of interest if consortia covered smaller populations of around 100,000.