The Commons health committee has delivered a devastating critique of primary care trusts.

Its inquiry into the next stage review not only slates their present capacity to deliver, but holds out little hope that they will ever be up to the task of implementing Lord Darzi's vision of quality and choice.

Management weaknesses are "striking and depressing", with a widespread inability to interpret and act upon basic data, it claims.

Shortcomings in PCT management have been well aired, including in HSJ. What is striking and depressing about the report is that it relies on second hand and out of date information to make its assessment.

It would have been sensible for the committee to call witnesses from PCTs to get first hand insight into how they were progressing before pulverising their management standards. Foolishly the MPs instead drew on other parliamentary reports from as far back as 2005. This is not an acceptable evidence base for what is happening 2009.


The Department of Health readily admits the first year of world class commissioning will be a struggle for many. This report was an opportunity to assess what progress has been made to date, and what further support the DH needs to provide. But in their rush to condemn PCTs with headline grabbing soundbites MPs failed to provide any meaningful analysis of this crucial issue.

The MPs quote approvingly one witness who claimed the NHS does not afford commissioning "sufficient status". It is difficult to square this with the extraordinary expectations around commissioning, which has been touted as the solution to pretty much everything.

The report contains little that is new and much that is old. Everyone knows there is a lack of clarity around the role of strategic health authorities, practice based commissioning is achieving little and it is going to be tougher to implement the next stage review when the government is short of cash.

The committee has delivered a shallow analysis which does little to further debate on this complex and occasionally contradictory policy drive.