'The DoH appears to be considering pushing PCTs to use independent sector treatment centres.- even to the extent of trying to steer patient choice'

The uncertainty in the North West over whether primary care trusts will be performance managed on the number of patients using independent clinical assessment and treatment services betrays a certain degree of cunning on behalf of the Department of Health - and a strange approach to patient choice (see 'Trusts face monitoring on take-up of private services').

In the first wave of independent sector treatment centre contracts, PCTs.were forced to pay the private sector regardless of whether the full capacity of the contract was used. In the second wave, which encompasses ICATS, any spare capacity is paid for by the DoH.

Free choice?

But the DoH appears to be considering pushing PCTs to use the centres - even to the extent of trying to steer patient choice.

The irony that the success of effective demand management through PCTs could exacerbate problems with the contracts is not lost on at least one PCT chief executive.

As an indicator of how the second wave of independent treatment centres will be controlled, it is not a promising start.