Some primary care groups are increasingly occupied with financial and organisational structure issues and appear to be losing sight of the key task of improving the population's health. Furthermore, some have expressed concern about sharing information with neighbouring PCGs.

It is important that all PCG chief executives and board members acquire, as a minimum, basic working knowledge of their organisation's finances. This should enable them to discharge their functions more effectively with their budgets. A key challenge for PCGs is to achieve their objectives within the finite resources available.

It is also important that organisations have the appropriate structures in place to deliver quality services. Time spent determining organisational structures is invaluable, but PCGs should appreciate the need for some degree of flexibility. This allows for future changes required by the NHS Executive and the dynamic external environment.

Many PCGs will be gearing themselves towards primary care trust status next year. PCTs, like PCGs, will need to continue to establish new working arrangements with various stakeholders, and will require to work in collaboration with other PCGs/PCTs. The current political climate promotes collaboration, not competition.

Finally, PCG chief executives and board members need to provide leadership by elucidating the organisation's purpose in broad terms and communicating this to all its staff. Clearly, the health of the population should form a core part of a PCG's mission statement. In the first instance I suggest that the word 'care' be replaced by 'health' in primary care groups. 'Health' engenders a wider remit of the work of these groups, suggesting that they have a duty not just to be reactive and provide care for patients who become ill, but also to be proactive and have concerns for public health.

Dr G S Kalsi

Specialist registrar in public health medicine

Sheffield HA