Published: 15/12/2005 Volume 115 No. 5986 Page 3

Primary care trusts in Greater Manchester will spend£2m more than they needed to on buying operations from its local independent treatment centre, as HSJ reveals this week (news, page 7). It is just the latest health economy to count the cost of being forced to pay for capacity that it will not use.

As HSJ revealed at the beginning of the year, the vast majority of trust chief executives believed the national procurement programme imposed unpopular solutions that did not match local needs (news, page 5, 20 January). As we wrote at the time, 'trying to shoehorn 500,000 private sector finished consultant episodes into an NHS whose growth plans were well established, while creating a commercial environment attractive enough to entice an understandably cautious private sector, was a recipe for trouble'.

Repeating a now familiar pattern of commandment followed by conciliation, the Department of Health seems to have learned from the experience. When Bob Ricketts, DoH head of access, policy development and capacity, spoke at last week's HSJ conference on diagnostics capacity, the message was all about flexibility - and a small serving of humble pie. The£161m programme to bring in independent capacity will start next autumn - crucially, PCTs will only pay for what they use, with the DoH left to worry about under-use.

That does not help PCTs - and there will be others - locked into compulsory contracts that they knew did not represent good value for money. It is to be welcomed that the DoH has learned from its mistakes in what was always going to be a challenging new landscape - but a shame that it is local trusts that are paying for the tuition.