Healthcare Republic reports on Wednesday that PCT debts are likely to transfer to GP consortia when the profession takes on commissioning.

So far, so grim. And could the health White Paper also allow patients flush with their tax-funded care allocations (or ‘patient budgets’) to choose their GP consortia?

According to the Financial Times, this could see the NHS becoming more like the Dutch health system where competing health insurers operate within a national system that offers broadly uniform coverage.

The FT writes: ‘What started out as more than 60 health funds has shrunk to only a little more than a dozen insurance companies, of whom four hold almost 90% of the market. They have to take all comers at broadly similar prices, the idea being that they compete over how well they commission care.’

Could the NHS ‘go Dutch’?

Well, the FT is right that no-one really knows how many GP consortia there will be, although 500-600 is a widely reported best guess.

It’s also right that there’s a nervousness amongst GPs about commissioning.

However, the analysis also seems to underplay the possibility that GPs and their consortia might make a decent fist of commissioning, embrace the BMA’s Look After Our NHS campaign, and see off the threat of private providers running consortia.

One of the key questions appears to be will the DoH allow patients to choose their GP consortia irrespective of geographic location? Our reading of the available documentation is that, yes, this is possible.

Health secretary Andrew Lansley says: ‘Accountability should be to patients who can exercise choice. Under our plans patients will have the ability to choose which GP they are registered with and, as we make clear in the White Paper, patients will have a greater access to choice, including choice of treatments.’

Not ruling it out then.

So, the NHS doesn’t appear to be about to ‘go Dutch’ any time soon but it’s an interesting and plausible theory and one GPs might do well to be aware of.

In the meantime, we’re compiling a list of consortia. Email me to join it at neil.durham@haymarket.com with your consortium’s detail.