Published: 09/05/2002, Volume II2, No. 5804 Page 5

The National Association for Primary Care has said it is 'gravely concerned' that power is not genuinely being delivered to primary care frontline staff.

NAPC fears primary care trusts - not GP practices and primary care staff - are now being seen as the front line, and devolution means increased powers to primary care managers rather than clinicians.

NAPC chair Dr Peter Smith said: 'We are now talking about a policy where power stops at the PCT level.' Dr Smith said the recent shift of emphasis called into question NAPC support for PCTs.

The complaint comes as PCTs around the country struggle to balance their budgets. It is understood virtually all PCTs have accumulated debt, in some cases up to£15m, and the demand to start paying some of the debt off is leading to the need to cut planned services. The total across the country is thought to be up to£1.5bn.