The government may find extra cash to meet the cost of clinical governance in primary care, health minister Alan Milburn hinted last week.
Responding to questions at a Royal College of General Practitioners conference, he said the issue of whether funding for clinical governance should fall outside the general management allocation for primary care groups was under 'careful consideration'.
'I view clinical governance and the quality agenda as central to the delivery not just of improved managerial arrangements in primary care but in improved clinical outcomes, ' he said.
'That might help shape the judgment that is eventually reached on clinical governance costs.'
Elizabeth Robins, a GP and primary care adviser to Avon health authority, had asked Mr Milburn to clarify whether funding for clinical governance would be included in the management allowance.
She said one calculation had shown that each PCG would need 0.5 wholetime equivalent staff to manage the clinical governance agenda.
Judy Gilley, deputy chair of the British Medical Association's GP committee, told the conference that PCGs would need extra funding for development on top of the£3-a-head management allowance indicated by ministers.
She said later that she 'strongly suspected' that clinical governance would be excluded from management costs.
She also suggested there had been a lack of precision in the calculations and costing policies for the first stage of PCGs in 1999-2000.
Dr Gilley also warned GPs that there was a huge amount of work ahead, saying: 'We are going to have to form new working relationships with an enormous group of people and that takes time and energy and skill.'
During discussions on resource allocation, Dr Gilley said the GP committee had asked for an increase in the overall budget to maintain out-of-hours improvements.
Detailed guidance on PCG resource allocation will be published shortly.
Mr Milburn used the conference to announce£5m to launch the second wave of personal medical services pilots.
The minister said the scheme enabled GPs to improve access for patients 'without being constrained by the bureaucracy of the Red Book' and opened up opportunities for flexible employment practices.
But Dr Gilley said the 80 first-wave pilots had cost GPs time and energy and should be evaluated before rolling out the programme further.