Published: 01/07/2004, Volume II3, No. 5912 Page 6

Structural distrust is built into the way the NHS is organised and it is going to get worse, delegates taking part in a session on relationships between acute and primary care trusts heard. Learning network OD Partnerships network director Gordon Best (pictured) presented a survey showing how PCTs described their neighbouring trusts and vice versa.PCTs described acute trusts as 'bottomless pits for resources', 'often hostile', lacking understanding of primary care, and often led by 'insular and arrogant' chief executives.Acute trusts said PCTs were 'suspicious', unable to commission, and led by leaders 'who do not measure up'.Mr Best warned that the inequitable distribution of targets created an asymmetric relationship between organisations and that the 'Jekyll and Hyde' role played by strategic health authorities, with a dual function to support and performance manage, did not help.