Primary care trusts will be forced to react to petitions from service users and the public if controversial proposals from the Department of Health get the go ahead.

Primary care trusts will be forced to react to petitions from service users and the public if controversial proposals from the Department of Health get the go ahead.

The commissioning framework released last week gives some detail to a proposal first set out in the healthcare outside hospitals white paper. If sufficient numbers of the public or service users petition the PCT over services, it would be expected to respond.

The framework says such petitions could include demand for new services or dissatisfaction with providers and provision. They could not be used to prolong debate on a proposed service reconfiguration after the end of a formal consultation exercise.

The commissioning framework sets out a series of questions, including who should be able to petition and over what services. It also asks how the voices of children, the
vulnerable, disadvantaged and excluded members of society can be heard.

Although it does not propose a threshold for the number of signatures that would trigger a formal response from a PCT, it suggests 1 per cent of the public served by a PCT or 10 per cent of the users of a service.

The proposals have raised fears that well-resourced and organised pressure groups could sway a primary care trust in their favour.

NHS Alliance vice-chair Donal Hynes said: 'In principle, anything that encourages greater public participation is a good thing. But public petitions are only one tool in the armoury and cannot be the only factor on which a PCT makes a decision, nor an excuse not to make a tough decision.'

NHS Confederation deputy director of policy Jo Webber said the proposals should be treated with caution. There was a danger of national pressure groups swaying local agendas, she said.

'It's right that people should be able to ask for what they perceive to be in their interests. There must be checks and balances in place to make sure petitions relate to the local population.'

She added: 'The detail will be really important here. The main thing will be to see where they set the thresholds for the number of signatures,' she said.