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NHS shake-up 'hands power to GPs' NHS shake-up 'hands power to GPs'
(about 1 hour later)
Doctors would pay hospitals direct under the new proposalsDoctors would pay hospitals direct under the new proposals
GP practices could be handed responsibility for most health services under a radical shake-up of the NHS in England, under ministerial plans.GP practices could be handed responsibility for most health services under a radical shake-up of the NHS in England, under ministerial plans.
Local trusts and strategic health authorities would be sharply scaled back to make way for their new role.Local trusts and strategic health authorities would be sharply scaled back to make way for their new role.
Health Secretary Andrew Lansley believes GPs are best placed to understand patients' needs and to decide where money should be spent.Health Secretary Andrew Lansley believes GPs are best placed to understand patients' needs and to decide where money should be spent.
But there are concerns GPs may not have the skills or will to take on the role.But there are concerns GPs may not have the skills or will to take on the role.
Others have questioned how they would be held accountable.Others have questioned how they would be held accountable.
Discussions with doctors' representatives over the plans are continuing, and the government has confirmed it will publish further details in a white paper next week.Discussions with doctors' representatives over the plans are continuing, and the government has confirmed it will publish further details in a white paper next week.
'Radical plans''Radical plans'
They involve setting up groups of practices which would work together in consortia, then buy in management skills, possibly from people doing the same job for existing primary care trusts.They involve setting up groups of practices which would work together in consortia, then buy in management skills, possibly from people doing the same job for existing primary care trusts.
At present, the government gives funds to local trusts which pay for patients in their area to be treated in hospital.At present, the government gives funds to local trusts which pay for patients in their area to be treated in hospital.
Under the new proposals, doctors would receive the money instead and pay hospitals directly for referrals.Under the new proposals, doctors would receive the money instead and pay hospitals directly for referrals.
BBC health correspondent Adam Brimelow said: "After six-and-a-half years shadowing the post in opposition, Mr Lansley has come in with detailed and radical plans to change the NHS."BBC health correspondent Adam Brimelow said: "After six-and-a-half years shadowing the post in opposition, Mr Lansley has come in with detailed and radical plans to change the NHS."
The acting chief executive of the NHS Confederation, Nigel Edwards, told BBC Radio 4's Today programme there were "some quite significant risks" in transition to the new system.
"Obviously it is going to take time to implement this and the PCTs at the moment are the people who keep the lid on the performance and financial management of the system," he said.
Mr Edwards also said the reform would move the NHS from a market where large organisations place big contracts, to one similar to the gas or telecoms market, where demand is shaped by many individual purchasing decisions.
"I think the concept here is lots of individual decisions by GPs - when they make referrals and send people to hospital - will be added up and we will have a greater market dynamic," he said.
"GPs will also help plan services and direct strategy for hospitals by telling hospitals what they need for the longer term."
Mr Edwards said he expected many GPs to recruit former staff from PCTs to help them cope with the additional workload, which will involve "quite a big step up from what they've been doing before".
Different challengesDifferent challenges
The NHS budget has been protected by the coalition government, and is not subject to the severe cuts of other Whitehall departments.The NHS budget has been protected by the coalition government, and is not subject to the severe cuts of other Whitehall departments.
But the health service has been told to save up to £20bn by 2014 to help it cope with the ageing population, rising drug prices and lifestyle changes such as obesity.But the health service has been told to save up to £20bn by 2014 to help it cope with the ageing population, rising drug prices and lifestyle changes such as obesity.
The Royal College of Nursing has claimed almost 10,000 posts - double the number from two months ago - are being cut despite government promises to protect frontline services.The Royal College of Nursing has claimed almost 10,000 posts - double the number from two months ago - are being cut despite government promises to protect frontline services.
A spokesman for the Department of Health said details of its plans for a patient-centred NHS would be published in a white paper shortly.
He added: "In recent speeches, the Health Secretary has set out the values and vision for an NHS centred on patients.
"He has already emphasised the need to liberate the NHS to focus on outcomes and improving results for patients, as reflected in the revised Operating Framework which was published on 21 June 2010.
"And in a speech to the BMA on 2 July, he highlighted the importance of empowering doctors and nurses in the NHS to deliver quality standards and services. The details of how this vision will take effect will be set out soon."
Are you a GP or a patient? Do you think GPs should take responsibility for health funding? Send us your commentsAre you a GP or a patient? Do you think GPs should take responsibility for health funding? Send us your comments