GP-led consortia will take charge of buying and planning care in April 2013. The Clinical Commissioning Coalition, set up to represent the groups, said doctors felt they were being blocked and coerced by local health chiefs.
Examples cited included groups being told to merge with others because they are considered to be too small and being given so little involvement with spending money that all they had power over was “paper clips”. The coalition said that the groups were being threatened with having their applications to “go live” in two years time blocked, which would mean the managers retained control of the budget.
This is despite the government having consistently refused to set a lower or upper limit for the size of the groups, believing patients would be better served by letting them develop naturally.
Areas to think about:
- Is this managerial unwillingness on the part of the PCTs to transfer power a deliberate delaying tactic, or simply an example of the kind of bureaucractic inertia that the reforms are theoretically designed to bypass?
- Can you think of a more charitable interpretation of the PCTs’ actions?
- How could such conflicts be resolved equitably?

Discussion
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