“The new NHS will be better because it will be run, by and large, by our GPs, who are best placed to understand the needs of patients”.

The restructuring of the NHS has been sold to the public partly on the basis that services will be commissioned by GPs as they are best placed to know what their patients need. However, this is a misleading claim for a number of reasons:

  • Commissioning health care services is a complex and specialised task that requires legal knowledge (e.g. about competition law) and understanding of the tendering process, as well as administrative and financial skills. GPs do not have the skills or time to do this. Commissioning will be handed over to support services, often run by private companies who may be linked to private health care providers.
  • Only a third of GPs are actively involved in the work of CCGs (and of these, many have links with health insurance or private medical companies).
  • GPs’ decisions about their patients’ needs are already being over-ruled (e.g. by Referral Management Centers) to minimize the number of patient referrals that GPs make.
  • GPs will have less time to spend with patients because of the demands of clinical commissioning.

Polls now show 73% of GPs feel they have been set up to take the blame for the rationing of healthcare.


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