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Commissioning: Viewpoint - White Paper offers new opportunities

Dr Michael Dixon explains why GPs should take an interest in the coalition's health White Paper.

Dr Dixon: ‘The White Paper gives us the power to make a difference’ (Photograph: Alex Deverill)
Dr Dixon: ‘The White Paper gives us the power to make a difference’ (Photograph: Alex Deverill)


The White Paper is the biggest change for general practice since the NHS was created in 1948. It offers GPs a unique chance to lead the NHS as commissioners and develop our roles as providers.

Vote of confidence
It is overdue recognition of the importance of the registered list and a vote of confidence after years of challenge and sometimes hostility from senior managers and politicians.

It allows us to extend our role from caring for the patient in front of us to influencing their health and health services outside the consulting room.

We formed the National Association of Commissioning GPs (the predecessor of the NHS Alliance) in 1994 to agitate for the right of GPs and their patients to influence health and services.

This White Paper gives us that right and without the divisions, unfairness and (sometimes) self interest that made fundholding unattractive to many.

Many GPs are understandably sceptical having lived through all these changes, but the White Paper does, potentially, give us the real means and power to make a real difference.

GPs as leaders
If you are not an idealist and just want to be left to see patients, then the White Paper is your potential survival plan.

It may mean accepting and welcoming the leadership of fellow GPs in commissioning and the peer pressure of colleagues to improve the way we practise and use resources. But surely that is better than the alternative of GPs having to work to the agendas of corporate concerns?

It won't be easy. Ahead there is opportunity, but also danger. Every GP must become involved in the consultation on the White Paper, not only to avoid those dangers, but also because it will have a huge impact on the future of our practices and patients.

Many senior managers and some secondary care clinicians are publicly doubting whether GPs are up to the task. It is depressing to hear GPs voice similar concerns. We are being invited to lead and, as leaders, we must work together to get the detail of the White Paper right and allow GP commissioning to create the primary care-led NHS for which so many of us have been endlessly waiting.

Listening events
The NHS Alliance is hosting four regional events on the White Paper in association with the RCGP. The half-day events will be in London (9 September), Wetherby (14 September), Leicester (29 September) and Newbury (5 October). For more details, visit www.nhsalliance.org

  • Dr Dixon is chairman of the NHS Alliance

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