PCTs must make right choices

Primary care trusts must be prepared to remove contracts from their local hospitals, even if the local trust is dependent on the money, health minister John Hutton said last week.

Speaking at a joint NHS Confederation and Royal College of GPs conference on primary care, Mr Hutton was asked if it was realistic for PCTs to be able to remove contracts from their local providers, even if they were not satisfied with the service provided, as the acute trust might depend on the money.

He said: 'There could be some very difficult decisions that colleagues could have to make, but you can't go on getting services that are not adequate. Should you be prepared to make those changes? Yes, you should.'

However, although he made clear that PCTs had to seize the agenda, he also said there are serious problems in general practice, adding: 'The primary care workforce is probably our greatest challenge.'

Dr Colin Hunter, national coordinator for primary care at NHS education for Scotland, said the new GP contract would probably have a big impact on workforce issues, particularly skill-mix:

'In 1990 [when the GP contract last changed] the number of practice nurses increased four-fold, and I think it will happen again.'

Dr Hunter said one of the important elements of the current negotiations on the new GP contract was ensuring there were adequate IT systems in place for GPs to be able to provide all the clinical data that will be required of them under the new contract.

South Yorkshire strategic health authority chief executive Mike Farrar, who is leading the negotiations for the confederation, said he hoped there would be an announcement on IT as part of the primary care funding allocations due shortly.

NHS Confederation chief executive Gill Morgan called on the government to allow the service time to sort out the problems resulting from decades of under-investment.