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NHS restructuring plans slammed

Date published: 11/01/2006

MPs have attacked government "streamlining" plans to slim down the numbers of primary care trusts, describing the move "ill-judged" and unlikely to improve the NHS as a whole. The health select committee in a report highlighted the "high" risks in fostering a patient-led NHS, adding it found little evidence that the costs would outweigh the benefits.

The report urged ministers to remain mindful of the ramifications for staff, noting major restructuring changes to the NHS incurred large costs. It also said there was no indisputable case for halving the number of PCTs and axing the number of health authorities.

"Major restructuring should only be undertaken if there is an overwhelming argument in its favour - in this case there is not," it said. The committee highlighted the dangers of "the cycle of perpetual change" prevalent across the health service, flagging up the period of average 18 months for organisations recovering from restructuring and noting it took three years for plans to bed down in any event.

Restructuring PCTs, which oversee 80 per cent of the NHS budget, was a case in point with "significant" negative effects likely to impact on core functions such as commissioning services, community health services and protecting public health. In terms of size, the committee encouraged the government to let PCTs develop "organically", with a "managed approach to sharing best practice in commissioning" where possible, as that would avoid "the hugely disruptive and costly impact of another root and branch reform". Committee chairman Kevin Barron said: "It is clear that there are lessons to be learnt from the difficulties that have arisen following the publication of Commissioning a Patient-Led NHS and I am pleased that the government seems already to be taking account of these.

"In particular, the government must ensure that in future, consultation on restructuring is fully inclusive right from the beginning of the process." The government estimates cutting the number of PCTs from 130 to 70 and reducing the number of strategic health authorities from 28 to nine could save £250 million. A poll for public sector union Unison suggested 71 per cent of Labour MPs opposed PCTs which focused solely on commissioning.

General secretary Dave Prentis said it was a "disgrace" health visitors, community midwives, occupational therapists and other workers, "the backbone of our local community services" were threatened with the transfer to the private sector. Health secretary Patricia Hewitt said the planned reforms aimed to create stronger and more effective PCTs, able to secure "the best possible" health and healthcare for all patients in every local area. "All the changes that are being made in the NHS are designed to achieve even better NHS services for patients. That is the goal and the test of everything that we do," she said.

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