Health Correspondent Alison Dayani talks to a Birmingham GP tasked with spearheading the Government’s most far-reaching health reforms for 60 years.

Dr Andrew Coward has seen a lot of changes over the past 20 years from his doctor’s chair at Kings Norton Surgery, but he has now been put at the heart of the most radical reforms of the NHS in decades.

Dr Coward chairs a group of GPs which has been picked as one of three “pathfinder GP consortia” in the West Midlands to pilot the plans before the programme is rolled out across the country in 2013.

The reforms will see £80 billion of the health budget handed to groups of GPs, who will have a final say on which services to commission.

Dr Coward’s South Birmingham Integrated Care Commissioning will move ahead with replacing Primary Care Trusts (PCTs) and putting power in the hands of GPs by next year, ahead of the 2013 schedule.

It means he will be the first to experience the benefits from April next year, but also any cracks in the system.

The GP is fresh from a Downing Street briefing with David Cameron and Health Secretary Andrew Lansley when we meet.

“One of its advantages is that it places responsibility with GPs who have their feet in the community,” said Dr Coward. “Public satisfaction rates for family doctors are the highest for any public servant.

“As a pathfinder, we are going early on this to see what works. This isn’t a revolution, it’s an evolution. This is the first time they are making it from the bottom up.”

His enthusiasm is not dampened by concerns that taking on management issues from finances and commissioning services to monitoring local hospitals will draw GPs away from their primary role of treating patients.

“The vast majority of GPs will be seeing patients and won’t be affected,” added Dr Coward.

“There are 26 GP practices in this consortium covering 155,000 patients from Edgbaston to Selly Oak and Longbridge. Only one doctor out of the consortium will have to work half time on the consortium and half at surgery. A couple of others will have some decisions and tasks to do.

“Doctors are not managers and if we try to be, it would be a mistake.

“The NHS got to the point 10 years ago where it was management orientated and we are now getting the right breakdown. Doctors can’t do it on their own and will have the right collaboration with managers.

“An integral part will be to transfer over some staff from South Birmingham PCT to work for us, but there will be some redundancies as the Government is spending £5 billion nationally a year on management and reducing it to £3.7 billion.

“It’s important that we quickly sort out who is being transferred as they are human beings and it will be better for them to know.”

With the background of cuts, the elephant in the room is whether these massive changes can work in the current economic climate.

“Andrew Lansley planned these changes as shadow Health Secretary in the context of an economic boom,” explains Dr Coward.