PRIMARY CARE Patricia Hewitt and Sir Nigel Crisp both apologise for being too prescriptive

Published: 17/11/2005 Volume 115 No. 5982 Page 7

The government has issued a double apology to the primary and community care workforce for ordering primary care trusts to pull out of providing services.

Health secretary Patricia Hewitt and her most senior civil servant, NHS chief executive Sir Nigel Crisp, both apologised within hours of each other during speeches at the NHS Alliance annual conference in Harrogate.

The official moves to appease primary care managers and clinical leaders follow widespread opposition to orders in July that, by 2008, PCTs should only be involved in direct provision where no alternative could be found.

Ms Hewitt apologised specifically for being 'too prescriptive' on the future of primary care provision. 'I know that many of you were very unhappy about what we said at the end of July in Commissioning a Patient-led NHS about the future of services that PCTs currently provide. I am very sorry that many staff have been caused such anxiety, ' she told the conference.

She added that the policy was 'clearly too prescriptive' and emphasised that it had 'changed'. 'As I said in parliament, district nurses, health visitors and other staff delivering clinical services will continue to be employed by their PCT unless and until the PCT decides otherwise.' Sir Nigel later denied the government had made a 'U-turn' on the policy when challenged by Portsmouth city PCT chair Zena Atkins.

'There was one line in the document where we said reduce [PCT] provision to a minimum. We also said where PCTs need to keep services they need to make sure the management of that provision does not interfere with the commissioning part of organisations, ' he said.

However, Sir Nigel repeated Ms Hewitt's apology that the policy had 'caused so much upset'.

'Many of you were unhappy about what we said at the end of July about the future of services currently provided by PCTs, and I am sorry if what we said caused so much upset.

'We have listened very carefully to what people said, and the upshot of that is, as you know, We are going to leave decision-making about service provision of PCTs to be made locally, ' he stated.

Sir Nigel also moved to clarify his proposals for the future role of strategic health authorities in managing PCTs, in a document leaked to HSJ (news, page 5, 10 November).

He said the document was 'part of a series' of papers and only 'told half the story'. 'What We are actually saying is what the development process is that people go through.

Our intention is to make sure that when new organisations are created they are not just a reshuffle of the old organisations but actually we start in the best possible way, ' he said.

He added that SHAs' role in developing PCTs over the next year would be 'enabling'.

'My expectation is that as people are going through this process of development there will be a period where SHAs will be working very closely with PCTs - very closely indeed in some cases.

'The length of that period will vary from PCT to PCT depending on their ability to deliver the whole range of their functions, but I expect PCTs to go through this really very quickly indeed, and be firing on all cylinders fit for purpose by this time next year.'

See more on the NHS Alliance conference, see page 9.