Health white paper: Concerns over new role for GPs


Disability charities have raised key concerns over the government’s sweeping and controversial plans to reform the NHS.

The health white paper, Equity and Excellence: Liberating the NHS, contains plans to give GPs more power, with groups of GP practices to be given responsibility for buying treatment from hospitals and other health providers.

Primary care trusts (PCTs) and strategic health authorities will be phased out, and patients will be able to register with any GP practice they choose.

The white paper also promises to “break down barriers between health and social care funding”, with closer integration between health and social care “at all levels of the system”.

And it reaffirms the government’s commitment to personal health budgets – in which patients are given control of the money to pay for their care.

But RADAR said it had concerns about whether groups of GP practices would be able to maintain the same “strategic focus” as PCTs.

Marije Davidson, RADAR’s senior policy and parliamentary officer, said she was also concerned about whether GPs would be held accountable for the impact of their commissioning decisions on disabled people.

And she said it would be unlikely that GPs would be covered by the specific duties that public bodies would have to meet as part of the Equality Act’s new single equality duty.

Davidson added: “We will try to be involved [with government consultations around the white paper]to make sure that disability equality is at the heart of those proposals.”

The mental health charity Rethink warned that most GPs would not have the necessary expertise to commission mental health services.

A survey of GPs for Rethink found that less than a third felt equipped to take on such a role.

Paul Jenkins, chief executive of Rethink, said that people with mental health conditions often say their GPs do not understand mental illness.

He said: “If they are to be given responsibility for deciding what happens to people with severe mental illness, then they also have the right to get properly trained up first.”

The white paper also includes a number of details about the government’s plans for social care, although many had already been announced.

It says the government will set out its “vision for adult social care” later this year, and will work with the Law Commission – which launched an overhaul of social care laws under the Labour government – to “reform and consolidate the law underpinning adult social care”.

The white paper also repeats the pledge to set up a commission on the funding of long-term care and support, with a white paper in 2011 and a new bill in next year’s Queen’s speech.

The Liberal Democrat care services minister Paul Burstow later announced £4 million of funding to support personal health budget pilot schemes – the same level of funding as last year.

The money will also help the government plan how to combine personal health budgets with social care personal budgets.

Burstow said: “We want to give people more choice and influence over their healthcare – giving them direct control of the cash is a powerful way of achieving this.”

15 July 2010