ABSTRACT
The creation of PCG/Ts has been a conscious attempt to engage local stakeholders, particularly GPs, in the management and governance of the NHS. That GPs should be the lead stakeholder in the development of PCG/Ts was enshrined in successive Government directives that trumpeted the need to devolve power and resources to frontline professionals such that the development of local health services would reflect local patients’ needs (Department of Health, 1997, 2001a; NHS Executive, 1998b). The rationale for GP leadership was also a condition of GP co-operation within PCG/Ts in order to retain the power and influence over decision-making that they had begun to enjoy through previous primary care-led purchasing schemes. Hence, the leadership and business conducted in PCG Boards and PCT professional executive committees have been GP dominated (Regen et al, 2001; Dowling et al, 2003 and see Chapter 5). Nevertheless, this lead role has been tempered by new collective responsibilities to work with quality guidelines, cash-limited budgets and in ‘equal’ partnership with other primary care professionals in multi-agency teams.
