GPs 'could replace health authorities as care buyers'

FAMILY doctors might end up buying all health care, in effect replacing health authorities, Alan Langlands, the chief executive designate of the National Health Service, conceded yesterday, writes Nicholas Timmins.

There was no 'hidden game plan or agenda' to achieve that, he told a London conference on the future of the NHS, and whether or not it happened would depend on what provided the most benefit to the population and the taxpayer.

But asked by a delegate whether in a few years he might be announcing that health authorities were on their way out and that GP fundholders would be the main or entire purchasers of health care, Mr Langlands said: 'I honestly don't know the answer to that question'.

The NHS changes had produced 'a huge national experiment' in purchasing health care and there were no longer just two models for doing it, either through health authorities or through fund-holders.

There were now eight or nine different combinations of GPs, health authorities and family health service authorities, working together in different ways through commissioning agencies and fund-holders. 'We need to think seriously about which of these produces the best results,' said Mr Langlands, who takes over as chief executive of the NHS on 1 April.

All of them needed to be properly evaluated, he said, to measure their benefits to the population served and to the taxpayer.

His comments came as a group of four GP practices in Bromsgrove, Hereford and Worcester, are to be given pounds 13m in the coming year to purchase all types of care, including emergencies, in the first national experiment of its type.

Mr Langlands insisted there was 'no hidden agenda' to achieve that nationally, but Ken Jarrold, the chief executive of the Wessex regional health authority, later hinted at health authorities having a more residual role in future.

He told the conference, organised by the National Association of Health Authorities and Trusts: 'I think there will be a role for health authorities of some kind.'

But he warned health authorities not to do anything to try to 'stifle' the fund-holders who take cash from district health authorities in order to buy care for their patients. Any health authority that did that would be 'dealt with', he said.