GPs 'losing faith with NHS reforms'

Ministers want GPs to be involved in PCTs

GPs appear to be losing faith with government efforts to modernise the NHS.

A new report suggests fewer GPs are now involved with their local primary care trusts.

PCTs were set up in England in April 2000 as the central plank of the government's NHS reforms.

They are responsible for coordinating and managing health services at a local level.

Modernising the NHS

They replaced health authorities and were hailed by ministers who said they would lead the drive to modernise the NHS.

Under the original proposals, local doctors and nurses were supposed to play a key role within the PCT, deciding where to spend money.

GPs feel hedged in and despondent Dr Mike Dixon, NHS Alliance

That policy was based on the theory that local GPs were much better placed to know what services were needed locally compared to health authority staff.

However, this latest report from a number of bodies, including the British Medical Association and the Royal College of GPs, suggests doctors have become disillusioned with the policy.

"Clinical involvement in PCTs appears to be lessening at a critical time for the NHS," the report says.

"Many frontline staff have become disillusioned with their role in them."

The report calls for key changes to encourage GPs to take up roles within PCTs.

These include extra managerial and administrative support.

"It is imperative that clinicians in primary care are fully engaged and involved in PCTs as frontline doctors, nurses and allied professionals have the best working knowledge of the needs of local communities," the report states.

The report's author Dr Julian Neal of the BMA said: "The government said they were going to put local doctors and nurses in the driving seat.

"That is no longer the case. It is being driven by others.

"PCTS are too unwieldy, they are dominated by managers and they are becoming the health authorities of old.

"GPs are best placed to make those decisions."

Dr Mike Dixon, chairman of the NHS Alliance which represents PCTs, said: "It's all about GPs feeling they can make a difference.

"A lot feel their role in PCTs doesn't warrant the effort they put in.

"They feel PCTs are not really able to implement things they want to see happen, they don't move fast enough or they are overly bureaucratic," he told BBC News Online.

"GPs feel hedged in and despondent."

A Department of Health spokesman said: "All clinicians must be able to play an active role in how their PCTs are run in order for them to work effectively.

"To support this, members of the National Primary Care and Trust Development Programme are working closely with the Department of Health, the National Association of Primary Care, the NHS Alliance, the Modernisation Agency's Leadership Centre and clinical leaders in PCTs to address the issue of clinical engagement.

"The work covers a range of issues which will ultimately provide clinical leaders in PCTs with the skills, support and development they need to ensure that they are able to engage with and influence how their PCT is run and contribute effectively to redesign of local health services."