The government’s health reform proposals are already resulting in a brain drain of management and commissioning expertise from the sector the Royal College of General Practitioners (RCGP) has warned.
The government’s health white paper proposes the abolition of primary care trusts and the creation of up to 500 GP consortia to commission health and social care services. Service user groups have already cast doubt on GPs’ level of expertise in commissioning care services for a wide range of conditions including mental health problems and learning disabilities.
“Members observe that many of the best managers and administrative staff [in PCTs] are already seeking and obtaining alternative employment, with the likelihood that those left behind may become demotivated,” read RCGP’s response.
It said GPs were already concerned that the rapid shift to GP commissioning would lead to a loss of knowledge. They proposed that GPs should be further integrated into the existing PCT structure to gain a greater voice for clinicians in commissioning while avoiding the loss of specialist knowledge.
However, the Local Government Group (LGG) argued that councils should retain a lead in commissioning many specialist services.
In its own response to the government consultation the LGG said local authorities had a strong track record in commissioning a mix of services in areas including mental health care, dementia and drug and alcohol services.
It argued that councils could also provide administrative assistance to the GP commissioning consortia.
The RCGP added that cuts to local authority budgets would make effective collaborative working difficult, especially on public health, which the government proposes to give local authorities responsibility for.
It warned that a postcode lottery in public health could evolve as a result of the changes.
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