Published: 14/03/2002, Volume II2, No. 5796 Page 6

Community health councils have voiced fears that some trusts may not set up patient advice and liaison services - PALS - because of a huge funding shortfall.

The NHS plan says a PALS service 'will be established in every trust' by 2002, 'with an annual national budget of around£10m'.

The same sum has been used to fund pathfinder PALS in 2000-01.

In January, the Association of CHCs for England and Wales claimed PALS could cost nearly£63m across England.New figures suggest the cost could be higher still - up to£78m nationally.

In a letter to NHS chief executive Nigel Crisp and London regional director John Bacon, seen by HSJ, Wandsworth CHC chair Donald Roy estimates the annual cost of the five existing and proposed PALS in the Merton, Sutton and Wandsworth health authority area to be slightly over£1m, based on data supplied by local NHS bodies.

This compares with the£129,000 share the HA has been allocated from the£10m redirected from pathfinder PALS into the hospital and community health services allocation across England for 2002-03.

Mr Roy's letter suggests that the Merton, Sutton and Wandsworth costs, if extrapolated across the country, would mean a total bill of£78m for PALS in 2002-03.

He told HSJ: 'St George's Healthcare trust is likely to get£26,000, against a current cost of£226,000. This is around eight times the earmarked funding.'

Mr Roy's letter estimates that PALS at Epsom and St Helier trust would cost£180,000, with£450,000 needed at South West London and St George's Mental Health trust and another£150,000 for the area's two PCTs.

St George's Healthcare trust was unable to confirm the current cost of its PALS, but said it consisted of a full-time manager, two-and-a-half full-time officers, an administrative assistant and a part-time information officer.

Operations and nursing director Marie Grant said: 'The service and financial framework rounds have not yet been completed.Once this has been done, the trust will be in a better position to comment on funding for the PALS service.'

ACHCEW director Peter Walshe warned that some trusts could duck out of providing PALS if money was short: 'This is yet another example of how illthought through the government's alternatives to CHCs are.

'The reality is that unless additional funds for the service are forthcoming, some trusts will not implement the service at all and some will do it badly. The PALSservice looks like being extremely patchy.'

A Department of Health spokeswoman said£10m was being made available for 2002-03 in addition to the£10m for pathfinder services in 2001-02, while 'an extra£23m will become available subject to legislation' - a reference to plans to abolish CHCs in the NHS Reform Bill.

She added that trusts 'should already be providing support and advice' and PALS would build on this.

Lords on the offensive Members of the House of Lords were set to launch a strong attack on key parts of the NHS Reform Bill, which reaches its Lords committee stage today.

The Lords are likely to support an amendment from Liberal Democrat peer Lord Clement-Jones to create patient councils as co-ordinating bodies for trust-based patients' forums, which was backed by Labour's Lord Rea and crossbench peer Lord Weatherill as HSJ went to press.

And junior health minister Lord Hunt has been forced to make concessions on plans for a new council for the regulation of healthcare professionals to 'direct' self-regulatory bodies.

Proposals to issue directions would now have to be laid before both houses of Parliament.