Supplementary memorandum submitted by
the British Medical Association (SAGE 32a)
Many thanks for the opportunity to appear as
a witness on 20 October 2010, I hope that the Committee found
the evidence session helpful.
In response to your question about the potential
shift to practitioner-led commissioning and the impact on a future
pandemic response, it would be premature to respond to this question
fully until the publication of the Government's Public Health
White Paper. The White Paper, which the Government states is due
to be published at the end of the year, will establish a Public
Health Service that will encompass existing health improvement
and protection bodies and responsibilities. We believe that local
authorities will have a public health role in coordinating the
response locally but we feel that consortia should be a focal
point of the organisation of local practices. As they will be
led by GPs, they will well understand the issues and level of
response which can be expected from practices. Whatever structural
changes are made, it will be essential for the Government to ensure
that there are robust arrangements in place to ensure efficient
coordination between the Departments of Health and local areas
in responding to a national emergency.
The implications of the National Commissioning
Board's role in centrally commissioning pharmacy will need to
be clarified, as pharmacies were used during the pandemic for
Tamiflu distribution at the direction of primary care organisations.
The role of central coordination in an otherwise devolved health
service will need to be clearly understood by everyone from the
Cabinet downwards. The structures that worked well in the last
pandemic did so because a small number of representatives and
experts agreed what had to be done on behalf of all the professionals
and organisations that had to contribute to the pandemic effort.
This should not be devolved away in the future.
I hope that you find this useful.
Dr Peter Holden
BMA General Practitioners Committee
10 November 2010
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