Lansley attacks 'damage morale and independence'

Health secretary Andrew Lansley, who has already made clear he believes many primary care trusts have failed on commissioning, last week published all PCTs’ and strategic health authorities’ 2009-10 spending on management consultants.

There is the danger of sending out an unfortunate message to future leaders of GP consortia

In a statement sent to national media with the title “new figures reveal extent of spending on NHS services at the local level”, Mr Lansley said he was “staggered by the scale of the expenditure”. The figure quoted was £314m - about 0.3 per cent of the NHS budget.

NHS Confederation acting chief executive Nigel Edwards said: “Much of the spend on consultants was in response to Department of Health policy imperatives. It is unfair for the department to criticise public servants - often in parts of its own organisation - for acting in good faith to enact government policy.”

For example, he highlighted the framework for procuring external support for commissioners (FESC). It set out how PCTs could buy in support to fill “gaps in their abilities” and identified several specific firms - mainly insurers and management consultancy firms - which could be used.

Mr Edwards said: “PCTs and SHAs are on the receiving end of a significant amount of criticism without any acknowledgement that they are crucial for maintaining performance and delivering change. I am concerned about the implications of this for the delivery of future reform.

“There is also the danger of sending out an unfortunate message to future leaders of GP consortia about the treatment they might expect in future over these sorts of issues.”

A PCT chief executive, who did not want to be named, said it was unfair to attack PCT managers for following policies such as FESC. He said: “PCTs were specifically encouraged and indeed instructed - the world class commissioning process virtually required you - to get external support. Any criticism should not be of PCTs. If there is criticism it is of the previous regime.”

The chief executive said there was a dramatic effect on staff morale from such criticism. He said: “If politicians go around saying you are crap - which is what they have been doing - of course that has an effect.”

Managers in Partnership chief executive Jon Restell said the attacks were causing those whose jobs were under threat to consider leaving more quickly, which would damage implementation of Mr Lansley’s reforms.

As HSJ revealed earlier this month, data suggests some PCTs have reined in spending on consultants so far this year. By the end of May or June, PCTs had collectively spent £9.4m, with 35 spending nothing at all.