More 'funding powers to GPs': Your comments

Surgery Doctors would pay hospitals directly under the new proposals

GP practices could be handed responsibility for most health services under a radical shake-up of the NHS in England, under ministerial plans.

Local trusts and strategic health authorities would be sharply scaled back to make way for their new role.

Here is a selection of BBC News website readers' comments.

NHS shake-up 'hands funding powers to GPs'

I am a GP. My heart sinks at this proposal. GPs are at the coal face. This means that though we are most aware of our individual patient needs, it is also hardest (and indeed immoral) for us to be taking decisions on what is effectively rationing, which should be something introduced at national level to make it fair. How reasonable would it be for me to decide not to refer someone for their hip pain or their cataract to save money? Or to decline to fund expensive cancer therapies, when perhaps a GP surgery down offers them?

Dr Chris Cullen, Hadleigh

I am a patient. I do not think that GPs should take responsibility for health funding as I do not believe they have the necessary administrative capability and support to do so.

Agnes Odejide, Upminster

I am a GP myself and I believe that if we need to provide the most cost effective service to our patients, this is the only way to go forward. The government plan is not that radical as GPs have performed the similar role of fund holding in the past. What is different this time is that the cat might have grown too big for the cage.

Adeel Riaz, Walsall

As a community psychiatric nurse, my main concern with this proposal is that GPs will have greater financial responsibilty or power. As it is, patients are often not referred on to specialist services by GPs in order to save money, and this will only exacerbate the situation.

Del Roberts, Liverpool

I am an NHS GP. The trouble is, I've heard this all before, from successive Tory and Labour administrations. After 20 years I am still waiting for that long promised "Primary Care Led NHS". Breaking the power of the central bureacracy and the specialist centres is much easier said than done. I note though that Langley portrays GPs as the dedicated and highly skilled professionals most of us are, in contrast to the image repeatedly spun by the last government of us as a bunch of useless greedy layabouts! That at least makes a pleasant change and makes me, for one, more likely to want to help with his agenda.

M Johnson, London

I've been working in the NHS for many years and I agree that this would in part be a wonderful idea. It will work brilliantly if the hospitals are directly funded and GPs separately so. The idea that non-specialists can truly understand the complexities of speciality care is rather ridiculous and this puts GPs into very difficult situations and just creates another maze of paperwork. If this is just another method of "rationing", then the government should just say so.

Dr CS Deshpande, London

GP fundholding was tried before and was widely judged to be a failure. GPs are busy enough being doctors; their time and skills should not be wasted on resource management. By definition, GPs are general practitioners and not experienced in all areas of medicine.

Dr Melanie Snape, Birmingham

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