Published: 21/03/2002, Volume II2, No. 5797 Page 6 7

The government has appointed consultants to develop the role of the long-stalled independent reconfiguration panel, promised under the NHS plan to consider major service changes.

But as protests against reconfigurations continue, managers and doctors are starting to examine ways to sustain services without reconfiguring. The Office for Public Management has been commissioned to carry out telephone interviews and simulation exercises with key stakeholders, while the government is expected to make an announcement signalling a boost in the panel's status.

The troubled panel - still consisting only of a chair - has yet to start work amid mixed messages about the powers of local government overview and scrutiny committees to refer matters to it or to the health secretary. A consultation document says the health secretary may seek the panel's advice 'if he wishes', though the NHS plan said scrutiny committees would 'be able to refer' reconfigurations meeting 'clear criteria' to the panel.

Peter Walsh, director of the Association of Community Health Councils for England and Wales, said: 'The current proposals seem to be a watering down of what was proposed in the NHS plan.'

London Health Link chair Elizabeth Manero has called for a duty on the health secretary to accept 'mandatory' referrals where service changes affect large numbers of people, affect small numbers 'to a significant extent', or involve a facility closing or relocation of services. She said: 'We still need more clarity about the status and accountability of the panel.

There is also an issue about referrals in the pipeline now, where people were under the expectation that the panel would be up and running by April.'

Areas where referrals are 'in the pipeline' include those at Kent and Canterbury (see story below right) where protesters were set to lobby Parliament next week.

MP Dr Richard Taylor - elected on a save Kidderminster Hospital ticket and now vice-chair of the all-party parliamentary local hospitals group - said the group had been warned 'more than half of all district general hospitals would have to be downgraded' due to shortages of key medical staff.

Lobbyists would be urging the government to look at proposals from the NHS Confederation and the Royal College of Physicians to link district hospitals to larger 'area' hospitals, he said.

Confederation policy director Nigel Edwards said: 'We think the European working-time directive and other things will mean medium-sized hospitals are starting to anticipate difficulties in the viability of some or all of their services.'A new way of approaching the problem was needed because 'there is not the time, the capital or the political will to reconfigure'.

A Department of Health spokesperson was unable to answer questions about the panel, but said its 'advice to the NHS' would be considered 'every bit as carefully as the advice we receive from the National Institute for Clinical Excellence and the Commission for Health Improvement'.