by Andy Howell

Do general practitioners (GPs) stand to make enormous profits on the back of the government’s GP commissioning reforms? Government ministers have responded to such suggestions aggressively, arguing that recent stories to this effect are simply the result of scaremongering of behalf of their political opponents.

However, talk to almost anyone involved in running local health services and they will tell you that it is inevitable that there will be huge profits to be made by GPs through commissioning, and they are not happy about it.

But if there are huge profits to be had, then how are they to be made and where will we have to look to find them? Will the opening up of GP services to profit-based ventures change the nature of our NHS forever?

It is not difficult to find experts in public sector organisation and finance who will tell you how they expect the new commissioning service to develop. Here is one such scenario that maps out what we might be letting ourselves in for.

Initially, I thought it might be difficult to monitor profits and to understand exactly how they were being made. After all, GP practices are not limited companies and as such they do not produce public accounts. But the experts tell me that it is not in established GP practices that money is to be made.

The new profits will come through newly commissioned services which, as limited companies, can be developed in very different ways to traditional GP practices. The key to understanding how the money may be made involves appreciating that local GPS will be able to be both commissioners of local services and providers of local services at the same time. There is no rigid separation of purchaser and provider here.

Let us consider two GPs who work on the same patch. Let’s call them Fred and Sally. (more…)