comment: Another look at how the top teams are coping is needed - fast

Published: 13/05/2004, Volume II4, No. 5905 Page 15

Modernisation Agency clinical governance support team director Paul Stanton last month described primary care trust management as 'anorexically thin'. It is a view given credence by a poll commissioned by recruitment and human resources consultants Hudson (news, pages 6-7).

The findings reveal that only a third of the PCTs surveyed had dedicated finance directors, with the others sharing the role with another PCT or asking their finance expert to carry out additional responsibilities, typically performance management.

One in three PCTs had no human resources director and, most worrying of all, only one PCT had a full time IT director.

This would be worrying enough in any era, but in the context of payment by results, the new GP contract, Agenda for Change and the national programme for IT - to name only the most obvious examples - it borders on the negligent.

Worse, though not surprising, is the discovery that this management drought is worst in the South, where cash tends to be strapped, waiting lists long and recruitment difficult.

Do we need more PCT managers? Those responding to the survey did not seem to think so. Instead they expressed most concern about financial pressures, targets and the reform process.

Since government is highly unlikely to find more money for the NHS or to ease off on its demands for improvement, it will have to think seriously about finding a way to facilitate a boost to PCT management capacity. The work and resources committed so far to achieving this are not succeeding quickly enough and another look at the issue is urgently required.