Ian Quinn - PULSE

Its official response to the coalition's health white paper warns the decision to do away with all trusts as well as SHAs risks causing financial chaos as PCTs ‘implode' leaving ill-equipped GP consortia forced to take over amid widespread confusion and a huge loss of corporate memory from the NHS.

'This is a very difficult climate in which to make substantial service changes and reconfigurations,' says the document. 'We would question the value for money of such changes and whether a less disruptive, more cost-effective process could have been proposed to achieve similar aims of reducing bureaucracy and empowering clinicians'

The response also calls for GP consortia not to be saddled with the debts being run up by many PCTs as they struggle to cope with the NHS cash squeeze and for far greater clarity over the functions they will be expected to take on.

However, the BMA told Pulse it was still hopeful it could persuade health secretary Andrew Lansley to drop plans for the handover altogether.

‘We are very keen to see a reduction in the bureaucracy that has burdened the NHS and a reduction in the size of PCTs,' said GPC deputy chair, Dr Richard Vautrey. ‘But we do question whether the removal of PCTs and their replacement with GP consortia is really necessary or whether there could be a more cost effective and quicker way.'
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The consultation warns a brain drain of some of the best NHS managers has already begun from PCTs, adding the BMA has ‘grave concerns over the possibility that PCTs may be phased out before consortia are properly established'.

Dr Vautrey said plans to slash PCT costs had already been launched by Labour's QIPP programme and claimed Mr Lansley could have achieved the transition of commissioning power to GPs by an ‘evolutionary rather than a revolutionary process', with the plan to replace PCTs bringing with it ‘huge transitional costs'.

Asked if the BMA thought the coalition could still be persuaded to reverse its plans he said: ‘It's not too late. Nothing is too late if the Government is to be believed that it is listening not just to GPs but also other organisations.'

But if it fails to save PCTs from the axe, the BMA's submission says there is a need for much greater certainty over the exact functions GP consortia will be expected to take on from PCTs and the possible debt.

‘We do not believe PCT debts should be passed on to consortia, as we believe this will prevent them from functioning to their full potential and will also discourage GPs from becoming involved in consortia,' the consultation response says.