Health secretary Andrew Lansley has attempted to play down the scale and pace of the white paper changes, following widespread concerns expressed in response to the consultation.
In a speech to the Royal College of GPs annual conference in Harrogate last week, Mr Lansley tried to allay GP fears about their lack of commissioning expertise and the loss of their frontline role by saying the changes were “less radical than often represented”.
He also backed away from sole ownership of the reforms, saying many were the result “of years of the all the political parties agreeing that’s what we ought to do”.
The majority of white paper responses from health sector organisations have warned about the scale and pace of the proposed the reforms, though some, like the King’s Fund and RCGP itself have backed its principles while questioning its time table (news, page 12, 7 October).
However, Mr Lansley told GPs they were already influencing commissioning by prescribing and referring, they would not need to be involved in the detail of contracts and he was not seeking to turn them into managers.
He said: “There will be contracting, negotiations and accounting and administration, but unless you want to do it yourselves, this is not your role. Your role is to make sure the services you provide are clinically led, put the patient first and focus on improving clinical outcomes.”
On speed of implementation, which has attracted most concern, Mr Lansley made no concessions to the timetable set out in the white paper. But he did use different language to talk about the transition.
Having previously rejected calls for GP commissioning to be piloted, he described the 12 months to 1 April 2013, when consortia take full responsibility for commissioning, as a “full dry run”. He also referred to fledging consortia, such as those in Cumbria and Cambridgeshire, as “pathfinders” – a term often used to describe policy pilots.
However, he issued doctors with a warning to put up or shut up, following his seven years on the shadow health bench. He said: “I’ve spent years listening to you and your colleagues say: ‘why do they not listen to us, we know how we could do it better’. This is your chance.”
Mr Lansley also denied suggestions that revalidation had been “kicked into the long grass”, after he announced an extension to its piloting in June, and confirmed practices which achieved RCGP accreditation – due to be launched in spring 2011 – would receive “light touch” monitoring from the Care Quality Commission.