Published: 16/05/2002, Volume II2, No. 5805 Page 6 7

Primary care trusts across the country are being forced to cut services and to produce service and financial frameworks which cannot be met, PCTs have said.

The struggle to cope with inherited debt is a problem nationwide, but difficulties appear particularly acute in London and the South East.

One PCT source told HSJ that the local strategic health authority had ordered PCTs to submit balanced SAFFs, to meet the statutory requirement for a balanced budget, even though it knew the PCTs would not be able to meet its requirements. And Enfield PCT executive committee member Dr Ron Singer said: 'The PCT has submitted a balanced budget for the current year, but in it is the statement that there is no money for some of the national service framework targets.'

Dr Singer said the worst-case scenario for this year was a budget deficit of£3-5m, and that although cuts had not been made to services yet, planned local priorities such as sexual health services and community nursing programmes could not be implemented.

Kingston PCT chief executive Janet Kells said: 'I have a deficit on provider services of 6 per cent. I am working with acute services locally on a recovery plan.We are aided by the positive support of the strategic health authority, but it is a very difficult position to start from and the GPs are very disheartened.'

A number of PCTs are examining the potential to cut services during the year. Hillingdon PCT finance director Russell BarnesHeath said his PCT had also submitted a balanced SAFF, but said it included a number of risks around negotiating service agreements and prescribing.

Mr Barnes-Heath said the development of children's services and older people's services had already been hit and that a potential deficit of about£5m could mean further savings were needed during the year.

Hastings and St Leonards PCT finance director Ken Ellis also admitted to problems balancing the SAFF.He said as it was unlikely the budget could be balanced, and said a recovery plan would be drawn up which was likely to mean rationalising services.

NHS Alliance chair Dr Michael Dixon said PCTs were being asked to pay off debt 'at an uncomfortably fast rate'.

He said: 'We all know it has been a really difficult SAFF round this year and there are pressures on PCTs to pay off debt.We are really on hold for a year.'

And National Association of Primary Care chair Dr Peter Smith added: 'Generally, people do not know how they are going to handle the deficits. The nonsense of it is, this is a new NHS and people are talking about cutting services.'

Government criticised over PCT control claims The NHS Alliance has said the government is wrong to claim that primary care trusts are controlled by 'GPs, nurses and other health and social care workers, plus representatives of patients and the community', as it stated two weeks ago.An alliance meeting of PCTs last week heard that PCT GP and nurse executive chairs were not given the same status as chief executives, and that the government was letting them down.The chief executive, lay board chair and professional executive committee chair are supposed to have the same status, but executive chairs are not even on Department of Health mailing lists, the alliance said.