TY - JOUR T1 - Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow JF - British Journal of General Practice JO - Br J Gen Pract SP - 860 LP - 861 DO - 10.3399/bjgp10X539407 VL - 60 IS - 580 AU - Mahiben Maruthappu AU - Kapil Sugand AU - Myura Nagendran AU - Laurence Leaver Y1 - 2010/11/01 UR - http://bjgp.org/content/60/580/860.abstract N2 - The coalition government recently revealed the ambitious task of ‘liberating the NHS’, a goal identified as the widest reforming change that the NHS has seen since its inception in 1948.1 The White Paper2 champions ideological aims to empower doctors while placing patients at the centre of their own management decisions, adopting the maxim ‘no decision about me, without me’.2 While such proposals have been optimistically publicised, on the surface heralding empowerment for both doctors and patients and rightly so, they nevertheless raise a pertinent question: is the motive to actually empower doctors or is it simply a shift of responsibility? At a time when there is financial pressure to cut costs of public services, many might cynically think that this is a way of government conveniently devolving the responsibility for ‘cuts’ which are soon to come; however, Mr Lansley did suggest some of the proposals in the White Paper before the global economic downturn.For GPs especially, the reform entails an increasingly managerial role in addition to their clinical duties. ‘GP consortiums’ will eventually control up to 80% of the NHS budget by 2013 when local primary care trusts (PCTs) are set to be abolished.2,3 The final outcome is intended to be a GP-led, bottom-up system, providing GPs with greater independence arguably improving their ability to provide patient care and optimise use of resources within their assigned communities. Of course, it may be challenging to commission services on unfavourable terms, and whether GPs will better understand the limits of what can be provided is still unanswered. Consortiums that work well to meet targets will be rewarded with lucrative incentives whereas struggling ones are unlikely to be bailed out, nevertheless special measures … ER -