Published: 01/09/2005, Volume II5, No. 5971 Page 6
Membership organisations are celebrating the Department of Health's move to veto early decisions on the future of services currently provided by primary care trusts (see story, page 5).
The NHS Alliance wrote to NHS chief executive Sir Nigel Crisp last week to warn in the strongest terms that the DoH must not let 'bureaucratic convenience' bring about 'long-term destabilisation of primary care services and widespread demoralisation of frontline staff'.
In the letter, alliance chair Dr Michael Dixon said: 'The message that is coming across is that the NHS is being carved up over a brief summer period when most of those affected are on holiday and have little or no ability to affect decisions.' He added: 'Clinicians are not commodities that can be shifted around like parcels in a left-luggage office.' The alliance named Birmingham and the Black Country strategic health authority as one of a number that were putting pressure on PCTs to come up with 'complete' plans for the future of PCTs, including their provider functions in their responses to the guidance. SHAs have until 15 October to examine and approve the plans before submission to the DoH.
However, Birmingham and the Black Country SHA chief executive David Nicholson described the accusation as 'ill-informed nonsense'.
'I concur exactly with what [DoH director of delivery] John Bacon says in his letter [clarifying that decisions on commissioning should be made ahead of those on provision].' 'His letter is absolutely the approach I've been taking from the beginning. It would be very dangerous to move on [provision] before the [healthcare outside hospitals] white paper. And the danger of moving too quickly is we end up creating all sorts of new monopolies which dominate patient care rather than creating a contestable market, ' he said.
The NHS Confederation, whose policy director Nigel Edwards said proposals to ban PCTs from commissioning and providing services while allowing GP practices to do both were 'intellectually incoherent', expressed delight at the DoH's 'clarification'.
And policy manager Jo Webber welcomed the 'clarity' of the Bacon letter: 'This clarification is extremely helpful and I am sure PCTs will find it very helpful as well, ' she said. Speaking about Mr Bacon's warning that there was no template for coterminosity, she said: 'It is a really important message that one number and size does not fit all, and the fact they need to take time to find and deliver the best arrangements to suit local services.
'Our members will welcome the opportunity to do the consultation of the healthcare outside hospitals white paper first and take into account the implications for the future of PCT-provided services, ' she added.