Health minister Ben Bradshaw has told primary care trusts to 'get their act together' to promote and deliver choice of treatment for patients.

In a frank interview with HSJ, the minister said the introduction of free choice earlier this month must lead to a cultural shift at PCTs.

He warned that any PCTs that were reluctant to promote choice would face tough sanctions. "Get your act together and be aware that the Healthcare Commission will come down on you like a ton of bricks," he said.

"This will be a very important part of the Healthcare Commission's ranking of trust performance. And PCTs failing to champion this will be named and shamed."

Primary care trusts would need to take the initiative, even if that meant taking politically difficult decisions to close services, Mr Bradshaw added. "I don't think it should be at all difficult for a well-run PCT which has got its communications right to be able to explain to local people why a particular service in the local hospital has to be reduced or even closed because it hasn't been up to standard [and] the public who pay for this have decided they want to be treated somewhere else where the quality is higher."

He also said the days when PCTs would both commission and provide services could be numbered.

"There are very big questions in the long term about that, but our feeling is that for the time being we can manage it, as long as there are clear dividing lines and this system of appeal to the independent co-operation and competition panel."

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