GPs don't commission hospital services directly though, that's the role of the CCGs - many of whom have commissioning experience before but some of whom have had to learn on the job. The acute sector services have always been commissioned through the services with the money from DOH, based on the needs of the local populations, whether it be the Health Authorities pre disbandment in 2002 or the PCTs until recently. The GPs' core services are funded now via the NCB, not the CCGs. It would be an interesting model to have GP services commissioned via the acute sector, and IMO we might well find ourselves back where we are now, if that ever happens - what does the acute sector know about primary care?
The whole thrust at the moment is to get patients OUT of the acute hospitals, which are hideously expensive to run, and into the community/primary care, which is why there is so much pressure on general practice at the moment.
You might like to see today's Roy Lilley blog, sqad. It might be said that it's a cynical view but it often says what people "up there" don't want to hear!
http://campaign.r20.constantcontact.com/render?ca=6e832709-1bfa-4098-8ebb-07aaf6f2ff75&c=9eecf690-b42b-11e3-9aa5-d4ae52733d3a&ch=3c6fa370-dab2-11e3-bd7a-d4ae529a824a