Quite why people are surprised that Andrew Lansley has stuck to his plans to introduce
GP Commissioning is a mystery. I’m struggling to recall one of his speeches or policy documents in recent years where it wasn’t mentioned. Anyway, let’s be clear, widespread
control of commissioning budgets by GPs was where the NHS was headed until Frank Dobson took over in 1997 and unravelled a decade’s worth of market based reforms. Rebuilding that
position has taken another decade of circular re-organisations to fix. No wonder the NHS is ambivalent about reorganisation.
These proposals are, of course, radical. But they are needed to address the fundamental flaws in the NHS commissioning landscape. The current system of commissioning – or buying
healthcare services – is considered weak by the Department of Health. Currently, GPs aren’t engaged in the process and Practice Based Commissioning (GP Commissioning without real budgets or
responsibility) hasn’t used scarce NHS resources efficiently.
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