According to a study by Pulse, an astonishing number of 95% of GPs did not have to undergo an election process in order to be appointed to the boards of new clinical commissioning groups (CCGs). The investigation was carried out amid claims of a ‘jobs for the boys’ culture and extensive withdrawal among grassroots general practice.
The investigation discovered after examining nearly 1,000 GP board posts across 150 prospective CCGs, that almost all were officially open for election, and only 7% were challenged. This has raised concerns that several GP officials are working without proper authority.
Numbers acquired from PCTs under the Freedom of Information Act reveal that only 53 out of the 770 elected posts were contested, and an additional 213 GP board members were selected without an election.
CCGs uncontested elections to GP board positions are represented in every Strategic Health Authority in England, with groups in the North East, West Midlands, London and Yorkshire among those to elect over 10 GP board positions uncontested.
The results of the study indicate that the profession’s engagement with the Government’s flagship reforms is significantly weaker than ministers have declared, and will raise considerable worries regarding the level of grassroots general practice interest in commissioning.
Guidance has been issued by the BMA suggesting that CCGs repeat elections when they take on legal responsibilities for commissioning. They also called for ‘periodic re-mandating’ each three years to make sure that grassroots general practices have a say.
GPC negotiator Dr Peter Holden voiced concern at the discoveries of the study, which he stated revealed a ‘pathetic’ level of engagement, he explained:
“It proves that people driving this are enthusiasts. My belief is competition is healthy for democracy. If these people have just walked in there they may not have the confidence of the profession that such a victory might imply.
My concern is the average GP has not realized the power of the CCGs. If we’ve elected people into positions of absolute power and authority without any means of calling them to account, we’ve just signed out own death warrant.”
A general practitioner who asked not to have their name revealed, told Pulse the lack of contested elections in her area revealed the process was biased against salaried GPs and locums, and warned of a culture within CCGs of ‘jobs for the boys’, she explained: “There are definitely the same faces in charge, specifically men. The elections were not inclusive to salaried GPs and locums or to female GPs who have got a family and commitments.”
Dr Una Duffy, a GP in Luton, Bedfordshire, stated:
“Our CCG looks like exactly the same people doing commissioning as we have had before. There is a widespread apathy to commissioning. Ordinary, working, heads-down, seeing-patients-every-day GPs are quite happy to let the current commissioning enthusiasts get on with it.”
The Department of Health explained that the number of pathfinders was evidence of GP engagement: “It is codswallop to say there is a lack of GP interest.”
Richard Hoey, editor of Pulse, commented:
“The Government’s NHS reforms are absolutely predicated on the idea that planning health services can be devolved down to frontline GPs and their colleagues.
But our findings are a damming indictment of the Department of Health’s attempts to involve and engage general practice. They suggest that clinical commissioning is being led by a small cabal at the top of the profession, which does not necessarily have the support of grassroots GPs, of a mandate commissioning, and many want nothing to do with it.”
Written by Grace Rattue