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Show me the money


Published: 25/03/2004, Volume II4, No. 5898 Page 26

HSJ's editorial denies my claim that primary care trust chief executives have a harder task than acute sector chief executives (comment, page 15, 26 February).

I stand by this claim because PCT chief executives have to lead on local health and commissioning, plus act as providers. To do this job well, rather than simply get by, demands the greatest skills of all.

Despite Shifting the Balance of Power and The Primary Care-led NHS, it appears the old assumptions remain.Health authorities and their chief executives are the bosses, acute trusts and their chief executives are the aristocracy and PCTs are a temporary aberration.

The truth is that PCTs are now centre stage and lead change, something which health authorities and acute trusts have failed to do with sufficient vigour and speed in the past.

A World Health Organisation report in January confirmed a mounting body of research showing that quality and strength of primary care provision is a main determinant of mortality, morbidity and equity in health, including mortality in hospitals.

French health minister JeanFrancois Mattei recently visited this country to see how our system of primary care helped to reduce rocketing costs in the secondary sector.

With primary care leading the NHS, the main determinant of a PCT's success is the quality of its chief executive.

If attracting the right talent means that PCT chief execs are paid more than acute sector chief executives, then so be it.

Dr Michael Dixon Chair NHS Alliance

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