The Prime Minister is reported to be
making five pledges on the NHS, but he is also reported to saying that the 2013 deadline for GP consortia will be scrapped so that consortia only go ahead when 'GPs are good and ready'. The reason for the deadline has been explained quite clearly by the Secretary of state. Fundholding was optional and lead to about half of GPs taking part, the result, as the White paper says:
Fundholding led to a two-tier NHS
More recently Lansley has said that he
does not want the deadline removed:
The health secretary has consistently argued that to allow GPs to opt in or out would create a “two-tier” health service, as what happened with GP fundholding in the 1990s. He believes two systems would hurt care and efficiency.
Get ready for the two tier NHS. The only question for patients is whether you are better registered to a GP practice out or in a GP consortium.
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The other reason for tiers is the free-for-all, cherry picking and lemon dropping for GP consortia. I can cherry pick a dozen of the top performing practices in East London and set up a super-mini consortia and leave the poorly perfoming practices to go to the wall, gradually taking over their lists when they go to the wall, so long as they look profitable. Otherwise I can leave their patients to rot.
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