“However we have a number of serious concerns and suggest the following recommendations:
1: COMPREHENSIVE HEALTH CARE
That the Bill should make it clear that the Secretary of State has a duty to provide, or secure provision, of a comprehensive health service throughout England.
2: CHARGING FOR HEALTH CARE
That commissioners or providers should not be able charge patients for health care services that are currently provided free by the NHS or are recommended by NICE.
3: ISSUES RELATING TO MARKET FORCES IN HEALTH CARE
That the Bill should place a duty on Monitor, the National Commissioning Board and GP Commissioning Consortia (GPCC) to enable collaboration to provide integrated services to meet patients needs without fear of a competition referral.
4: ISSUES RELATING TO EU COMPETITION
There needs to be clarity as to the legal implications of EU competition law (particularly when, and in what circumstances, it is enforceable) and other contractual and regulatory details.
5: ACCOUNTABILITY AND CONFLICTS OF INTEREST
Consortia must remain publicly accountable for all commissioning decisions, so that Board minutes and financial decisions are open to public scrutiny, including details of payments made to GPs or Practices for non-general medical services, including payments to private companies in which GPs have a financial interest.
6: RESOURCE ALLOCATION AND RISK POOLING
That there is clarity as soon as possible as to which allocation formula will be used for allocation to GP consortia for commissioning hospital care.
7: PRACTICE BOUNDARIES
The proposal to undermine the relationship between a local GP and local patients by abolishing practice boundaries is revised.
8: WORKFORCE AND TRAINING ISSUES
Given that the education and training proposals mark a revolution in medical education and could be harmful in primary care, we urge a careful and detailed reconsideration ahead of any implementation.
That there is as an absolute assurance that the Bill will not force doctors to breach their duty of confidentiality.”
81. The future NHS must build on the strengths and values of today’s health service, in particular building on the strengths of general practice. The benefits of modern general practice are well documented, with significant evidence that a good relationship with a GP, preferably over several years, is associated with better care, more appropriate care, better health, and much lower health costs.45
82. Irrespective of the outcome of these current reforms, the RCGP will continue to promote the development of high-quality, effective patient-centred care, with GPs at the heart of NHS service delivery.46
83. The RCGP recognises that the NHS needs reform and we would welcome the opportunity to work with the Government to further develop proposals to maximise benefits for patients
84. In the meantime we shall continue to offer leadership and guidance to members as they seek to deal with the consequences of the NHS reforms. We are engaging with our members to provide input to the Prime Minister’s Listening Exercise and will continue to develop further proposals for reforms of the NHS which place patients at the centre and promote family medicine. We shall also provide guidance, education and training opportunities, and through the RCGP Centre for Commissioning, shall ensure the sharing of good practice to assist GPs to develop the necessary skills to lead effective clinical primary care within the context of GP commissioning consortia.”