NHS reforms

SallyG

http://www.telegraph.co.uk/health/healthnews/8446782/Patients-are-denied-high-cost-drugs-by-NHS-trusts.html

"The Department of Health stressed, however, that GPs are “independent contractors and are not obliged to follow PCTs’ suggestions”.
“Doctors should prescribe medicines based on clinical need. They should involve their patient and take account of clinical suitability, risk assessment and value for money. They are legally obliged to fund treatments and drugs recommended by Nice,” said a spokesman.
The complaints may be used to justify the Government’s NHS reforms, which would see PCTs scrapped and GPs given the power to decide how NHS money is spent"
How will GPs decide how NHS money is spent?

SallyG

GP Consortia.

Not very comforting
http://www.guardian.co.uk/healthcare-network/2011/feb/03/who-owns-gp-consortia-colin-talbot
"Pardon my ignorance, but I have been trying – and I confess failing – to try and get my head around a simple question: who owns (or rather will own) GP consortia? The legal status of these bodies may seem a bit pedantic, but it could have a fundamental affect on the dynamics of the New Model NHS. And finding out, from the 367 pages or whatever it is of the health and social care bill is nigh on impossible.Most people forget, if they ever knew, that GPs are not NHS employees but independent contractors. Although some work in NHS premises, many (most?) own their own buildings and single or group GP practices are small businesses. Many GPs have already done very nicely by using NHS funding – quite legally – to improve buildings and businesses that they own.
Primary Care Trusts (PCTs) are, on the other hand, publicly owned and controlled bodies. GP consortia (let's call them GPCs for short) seem to have a rather more ambiguous status. Are they public, or are they private, or some sort of hybrid?
The reason it matters of course is that if these GPCs are going to be managing 80% of the NHS budget, or £80bn in today's budgets, what incentives will they have? If, for example, they are essentially private small businesses then the is every incentive for them to bias decisions in their favour. Because, when they are "commissioning" care they could, if the system allows this, commission themselves instead of NHS trusts to provide services. This could be either as a GPC or, presumably, as GP practices? Either way, they could stand to make money, either directly or indirectly, from such decisions."