Government warned reform plans will 'turn NHS upside down'

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PCTs are to be abolished from 2013 and SHAs in 2012-13 under the government’s ambitious plans to transfer commissioning powers to GPs.

The Department of Health white paper, Equity and Excellence: Liberating the NHS, published today, expects these plans will reduce NHS management costs by more than 45 per cent by 2014.

The document says that “following the establishment of the NHS commissioning board and a comprehensive network of GP consortia, PCTs will no longer have NHS commissioning functions”.

The vision is for a comprehensive system of GP consortia to be in place in shadow form during 2011-12, taking on increased delegated responsibility from PCTs.

The government hopes that following passage of the Health Bill, GP consortia will take on responsibility for commissioning in 2012-13.

A newly created NHS commissioning board will make allocations for 2013-14 directly to GP consortia in late 2012.

GP consortia will take full financial responsibility for commissioning from April.

The document says: ”We want implementation to be driven bottom-up, with GP consortia taking on their new responsibilities as rapidly as possible, and early adopters promoting best practice.”

It adds that despite their impending abolition, “primary care trusts will have an important task in the next two years in supporting practices to prepare for these new arrangements”.

Responding to health secretary Andrew Lansley’s statement in the Commons this afternoon, shadow health secretary Andy Burnham called the plans “an £80bn gamble” and said that there had never been an NHS reorganisation that had not cost money in the long term.

King’s Fund chief executive Chris Ham said this was the most radical programme of reform since the inception of the NHS in 1948 and it was “effectively turning the NHS upside down”.

He feared that replacing 148 PCTs with 500-600 GP consortia would not be easy and might actually increase management costs in some parts of the country.

PCTs’ responsibility for public health will pass to local authorities. The separation of community services from the current PCT commissioners will be completed by April 2011 and there will be a move as soon as possible to an “any willing provider” approach for community services, reducing barriers to entry by new suppliers. In future, all community services will be provided by foundation trusts or other types of provider.