Labour policy is 'fatally flawed' majority of PCT claim

The government's policy on primary care provision has become 'fatally flawed' because of poor handling, a poll of primary care trust chief executives suggests. More than three quarters of respondents to an HSJ survey agreed with the statement that 'a badly communicated policy has now become a fatally flawed policy due to government panic'.

In July's Commissioning A Patient-led NHS policy paper, the Department of Health said it wanted PCTs to divest provision by 2008. Since then, the DoH has urged strategic health authorities not to include decisions on provision in their structure proposals.

And last month, following union and backbench discontent, health secretary Patricia Hewitt told parliament that decisions on whether PCTs should divest services to the private and voluntary sector should be left to individual PCTs.

The survey shows that 36 per cent thought the statement would make no difference, and that stopping provision would still be 'as good as' compulsory. A further 51 per cent expected to gain 'a little more' flexibility while 13 per cent took Ms Hewitt's statement at face value.

Although two thirds of chief executives would like to retain more than half of their services if they were given the right to choose, most believe they will not be allowed to.

Ninety-five per cent of those polled said 'the government badly underestimated how much opposition would be created by the transfer of staff out of the NHS'.

One chief executive said: 'The Stalinist regime at the DoH increasingly appears to have lost touch with reality. In my 20 years at the top I have never known anything to affect morale to such an extent.'

Another disputed government claims that PCTs could not concentrate on commissioning while continuing to provide services: 'The problem of ineffective commissioning lies in the imbalance in status and power between commissioners and acute trusts.'

More than 40 per cent of the survey's 67 respondents believed that, after 2008, less than a tenth of the services they currently provide will still be provided by a larger version of their PCT. Only 27 per cent expect more than half of their services will remain in the hands of PCTs.

Fifty one per cent of chief executives believe it is likely or very likely that services will be handed over to the private sector as soon next year.

They think it is less likely that the voluntary sector or a local foundation trust will have picked up the services.

Patients left out in the cold on local consultations

Fewer than half of patient and public involvement forums have been consulted on proposals to cull primary care trusts, a survey has revealed.

The Commission for Patient and Public Involvement in Health found that only 39 per cent of forums had been consulted and only 22 per cent of these felt it had been meaningful.

CPPIH chair Sharon Grant said the results showed not enough PCTs were consulting on the changes.

Since the survey, the government has said there will be a three-month consultation on the reconfiguration.

But Ms Grant said she had been contacted by angry forum members who felt they were being excluded: 'It is shocking that so little meaningful consultation appears to be taking place,' she said.

http://www.hsj.co.uk/nav?page=hsj.news.story&resource=3600467