Hewitt calms PCT anxiety

Health secretary Patricia Hewitt this week admitted that the government's plans to transfer the bulk of primary care trust services to other organisations by 2008 had created 'understandable fear and anxieties'.

However, she hoped those fears would be replaced by a 'sense of the great opportunities' once the government had time to 'discuss them more with staff, their unions, and professional organisations'.

The concern is partly due to the possibility of the independent sector taking over some services. Ms Hewitt, stressing the reforms were in 'the very early stages', said she did not yet know what proportion of services might be taken up by private providers.

Speaking to HSJ at the Labour Party conference, she said: 'I know there has been a lot of anxiety and question marks raised by our fairly brief statement that we expect most PCTs to have moved their services to other providers by 2008.

'This flows directly from the need for stronger commissioners, because it is very difficult for PCTs, if they're really concentrating on that commissioning function and supporting GPs in practice-based commissioning, to also be employing large numbers of people delivering services.

'Changes in PCT structure are very much about having strong commissioners that can hold acute hospitals to account and stop them from just sucking up all the money.' Ms Hewitt stressed that the Department of Health would 'not be taking proposals on the provider aspect into account when we look at structural proposals around mid-October.' She cautioned against PCTs 'jumping the gun', adding: 'I've heard one or two examples in the last few days of PCTs who are saying 'We have already decided what the new organisation on the provider side will be'. Well they can't do that.

It has to be the new PCTs who take the white paper and run with that.' The health secretary said that, following the publication of the healthcare outside hospitals white paper at the turn of the year, there would be 'a lot more consultation around the details of how you assess and translate what patients want.'

'Much more to do' - Hewitt on the big picture

Moving on to wider health service reform, Ms Hewitt said there was 'much more to do to explain to people why We are making the changes We are making'.

However, she added:

'I've had a lot of conversations with managers and chief executives and I haven't found people who do not really understand the hospital reforms when they really need to.' Addressing specific reforms, she said: 'Choice over providers responds to meet people's rising demands, but it also helps to increase the levels of innovation across the NHS and challenge poor performance.

'Payment by results is there to support patient choice and ensure all our hospitals understand what different treatments are really costing, so we actually manage our vastly increased budget better than we sometimes have in the past.'