Welsh health minister Jane Hutt has announced the results of her consultation on the reorganisation of the NHS in Wales, with significant changes to her original proposals.
The shake-up will see the 22 local health groups - the Welsh primary care organisations - given statutory status as local health boards, while the five health authorities will be abolished.
But Ms Hutt has been forced to drop plans for three regional consortia of LHBs to commission secondary care services. She conceded that these were 'dead in the water' at a meeting of the Welsh Assembly's health and social services committee earlier this month, where opposition Assembly members derided the scheme as a 'Calamity Jane' approach.
In a speech to the full Assembly last week, Ms Hutt said 'the weight of consultation' had raised concerns about the consortia. 'I have decided not to pursue this proposal, ' she said.
Instead, Wales will have 10 to 12 local partnerships, mostly made up of two LHBs, two local authorities and a trust.
The NHS Confederation Wales welcomed the changes. Director Richard Thomas said: 'It is clear. . .
that the minister has looked closely at the suggestions put forward during the consultation process. Getting the structures right is important. . . The minister has shown she is listening to NHS management across Wales.'
The confederation had raised a series of concerns about the consortia in its response to the consultation.
One NHS source said: 'The key reason why the partnerships are better is to recognise the important vertical link between primary care and trusts.' The consortia idea had been 'partly the trusts' fault because they said We have had a big reorganisation, so do not touch us'.
Ms Hutt has also rejected an alternative integrated model suggested by the trust and HA chairs and chief executives group, which would have brought together primary, community and secondary care into combined provider organisations, with the Assembly providing the commissioning function.
A senior NHS manager told HSJ: 'That would be an absolutely fundamental reorganisation. It would mean the dissolution of all the existing trusts.'
Ms Hutt also announced a strengthening of the NHS directorate at Assembly level, 'both in the way it is organised and also in the range of skills directly available to it'.
Assembly offices based in north, mid/west and south Wales would 'enhance strategic planning, performance management and other operational functions', she said.
'They will hold lead organisations to account on a day-to-day basis on behalf of the director of the NHS in Wales.'
There will be a primary care directorate at the Assembly and lead directors for hospital and community-based services, mental health and children's health services.
NHS public health services would be organised on an allWales basis, located in a trust but with accountability to the chief medical officer, Ms Hutt said.
The Assembly is due to debate the reorganisation on 27 November.
Ms Hutt promised to publish a framework development plan in advance of the debate, including specific milestones to be achieved between now and April 2003.