Half of Primary Care Trusts to close in NHS efficiency drive

The Department of Health is planning to axe more than half of Britain's 302 Primary Care Trusts, which were created only three years ago. Sir Nigel Crisp, the chief executive of the Department of Heath, has written to the 28 Strategic Health Authorities urging them to make substantial cuts to the trusts, which purchase services from hospitals on behalf of general practitioners.

The strategic authorities will respond to the consultation in the next few weeks. The Department of Heath aims for the number of trusts to fall to fewer than 150 - perhaps as few as 128.

Crisp said that cutting the number of trusts could save £250m over the next few years. "These funds can then be redirected straight to front-line services," he added.

The reduction in the number of trusts will raise questions about their creation, a scheme that cost more than £63m.

However, the Government says it remains committed to these smaller health authorities, as they allow local communities greater power over their health services.

The proposed closures have attracted criticism from Alan Milburn MP, who was health secretary when the trusts were established. The MP is furious about plans to merge a trust in Darlington, his own constituency, with a larger County Durham authority. He told his local newspaper that the proposal was "ludicrous".

The cuts are expected to result in thousands of job losses and the department has begun talks with civil service trade unions The department said last night: "We are committed to reducing the excess bureaucracy in the management of the NHS. It is far too early to be talking about the number of job losses. There will be a reduction in the number of top management teams and back-office units."

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