The fiasco over the NHS non-emergency phone line 111 raises questions yet again over the policy of GP commissioning.
Many family doctors were ambivalent about being asked to take on the role of commissioning services, for the simple reason that they went into medicine to cure patients, not deal with contracts.
There were also concerns about their ability to carry out the function and calls for proper support to help them develop the necessary skills.
The procurement of many 111 contracts took place during the murky transition from primary care trusts to GP-run clinical commissioning groups (CCGs), so direct responsibility for the current problems may be difficult to pinpoint.
However, now CCGs are fully in charge, there are justified fears about the handling of critical contracts like 111.
When challenged about failure in the procurement of the contracts, a Department of Health spokeswoman said: “Procurement was done by local commissioners who commissioned services for their own areas. They were subject to the normal rules on procurement and best placed to identify what was needed in their areas.”
That seems to suggest local commissioners are on their own on this one, despite arguments that perhaps such important contracts should be handled centrally.
NHS Direct has said its 11 contracts were “financially unsustainable” and they will be “seeking to agree a managed transfer” to alternative providers.
A spokeswoman said there was nothing in the contracts to say what would happen if such a situation came about.
So the question remains: are CCGs geared up to deal with such important contracts?