Coalition plan to give GPs more power comes under fire

Council chiefs have raised concerns that coalition plans to transfer commissioning powers from primary care trusts to GPs could weaken accountability in the health service.

David Parsons, chair of the Local Government Association improvement board, said he had spoken to health secretary Andrew Lansley over the coalition’s plans to strengthen GPs’ commissioning role, leaving PCTs as commissioners of “residual services”.

Speaking at a conference organised by the King’s Fund on Monday, Parsons said: “Although I think it’s important they should have a huge say in the health service, [GPs] aren’t the people who can provide democratic accountability. They shouldn’t be the accountable body for health.”

Though PCTs are not democratically constituted they typically have formal partnership arrangements with elected councils, often including pooled budgets. The coalition also plans to boost PCTs’ democratic credentials by introducing directly elected board members and others appointed by local authorities.

However, the NHS Confederation is predicting that fewer councils will share boundaries with PCTs in future due to mergers to create fewer and larger trusts.

Shared boundaries between PCTs and councils – which have been installed in many areas in recent years – have been seen as important in driving integration.

Although the coalition has not pledged to redraw PCT boundaries, the confederation said plans to cut NHS administration costs by a third implied reductions in PCT numbers.

Jo Webber, deputy director of policy at the NHS Confederation, said PCT mergers “may take away coterminousity”, where councils and individual PCTs share boundaries, though she said this would not necessarily weaken joint working.

It has also been reported that the coalition plans to scrap regional strategic health authorities, which sit above PCTs.

This article is published in the 3 June 2010 edition of Community Care magazine under the headline Plans for GP Power Come Under Fire