Primary care trusts have been criticised by government ministers and opposition MPs for sparking public protests by their handling of reconfigurations.
Health minister for reform Lord Warner told the Conservative-backed Community Hospitals Acting Nationally Together (CHANT) group that some trusts were 'pretty inept in the way they go about' consultations on service reconfiguration, 'presenting a fait accompli' rather than involving local people. He warned that they should instead be 'open and transparent about consultation in the community'.
Conservative MP Graham Stuart said PCTs were 'unelected and unaccountable' and warned 'the present system is a substitute for democracy'. Trusts were steamrollering overview and scrutiny committees over proposed closures because they turned up with a group of senior managers 'who know their subject backwards' yet gave councillors huge piles of paperwork to read at short notice, he said.
But Lord Warner said the health secretary was accountable to parliament for the allocation of NHS resources. At local level 'it is in the job descriptions of PCT boards of directors to account publicly for how they spend that money'.
Shadow health secretary Andrew Lansley also hit out at PCTs. They 'have been a disaster in commissioning, use of resources and value for money,' he said, citing the Healthcare Commission's performance ratings.
The meeting came the day after the Community Hospitals Association, working with CHANT, released figures showing community hospitals in constituencies held by Opposition MPs are seven times more likely to be threatened with closure than those in Labour seats.
Mr Stuart, chairing the CHANT event, told HSJ: 'The data shows nine out of 10 hospitals that have closed in the last six months were not in Labour constituencies. There is a growing perception this is about politics, not the health needs of local areas.'
But Lord Warner warned CHANT that local hospitals were not 'future proof' and had to adjust to meet the demands of new technology and rising patient expectations.
Change 'requires new types of buildings and facilities but it also requires people locally, in an honest and transparent way, to discuss what is the best way of providing services now and in the future'.
Mr Stuart told the minister that the closure of community hospitals would affect plans to move care out of the acute sector and closer to patients' homes.
But Lord Warner blamed PCTs for getting their priorities wrong: 'We need to be clear that people should not make decisions on the future of community hospitals based on short-term financial considerations. It should be about patterns of service in the future.'