GP leaders from four national bodies have issued a joint attack on Southend primary care group's application to become a primary care trust next month despite a ballot in which local GPs opposed the move.

Although 58 per cent of GPs rejected the plans, health minister John Denham approved the application. But he insisted that the PCG board must demonstrate significant movement on support among GPs.

The statement from the British Medical Association, the Royal College of General Practitioners, the NHS Alliance and the National Association of Primary Care was issued days after the Commons heard Conservative MP David Amess describe the 'travesty' of appointments to the shadow PCT.

In a parliamentary question, Mr Amess, MP for Southend West, revealed that PCT chair-designate Katherine Kirk had been featured in a highly critical internal report about South Essex health authority, which she chairs.

The report by Redbridge and Waltham Forest HA chair Peter Brokenshire followed a breakdown in relations between board members, particularly Ms Kirk and chief executive Graham Butland.

The situation had become so critical that it 'almost reached breaking point, and only good professional behaviour from both of them since has kept things going, with external appearances belying very fraught personal relationships' the report says.

Ms Kirk had expressed 'a loss of confidence' in Mr Butland, while he felt the chair 'does not understand the NHS and big organisation realities, raises expectations that cannot be met, gets involved in management issues and does not focus on the big picture', it adds.

Both Mr Butland and Ms Kirk told HSJ that the report's recommendations had been acted on and that relationships between board members were now good.

Ms Kirk said she felt saddened that her appointment as PCT chair had been linked to the ballot 'in an attempt to politicise a non-political issue'.

But local GP Dr David Pelta said 'the appointment is clearly political', raising the fact that Ms Kirk is 'an active member of the Labour Party'. Ms Kirk said the move to a PCT has 'overwhelming support in the community', and was confident the PCT will be able to win majority support among GPs.

Dr Pelta called for the removal of the PCT chair and chief executive to restore confidence in the process of moving to a trust.

The local medical committee has called for a second ballot of GPs.

See news focus, pages 14-15.