Warning over NHS restructuring plan

Evidence suggesting GPs will be more effective than health trusts at commissioning NHS services "is weak", a report has said.

Think-tank Civitas said the "only possible justification" for restructuring could be that "GPs will be universally and significantly better" at it than primary care trusts (PCTs) who currently hold the purse strings.

The report also said the Government's plans would lead to a "one year dip" in performance in the NHS in absolute terms.

The NHS can expect to be set back at least three years "relative to what could be achieved without any structural change".

Health Secretary Andrew Lansley will flesh out his aims in a White Paper next week, which could see around £80 billion - 80% of the NHS budget - handed to family doctors.

The role of strategic health authorities and PCTs will be dramatically scaled back.

At the moment, PCTs control most of the NHS budget, commissioning services for patients in their area.

But Mr Lansley believes GPs are best placed to understand patient needs and to decide where money should be spent.

He has also said GPs must be involved in commissioning out-of-hours care, which has come under fire since PCTs took control. The plans involve setting up groups of practices which would work together in consortia.

The latest report from Civitas said a similar plan from the Tories in the 1990s - GP fundholding - improved speed, reduced waiting times and widened the range of available services. But it failed to reduce costs as much as expected and there was lower patient satisfaction with services, it said.