PCTs: From being “champions for patients” to being abolished – in just two months

Yesterday's announcement that all 302 Primary Care Trusts in England will be abolished by 2013 with more power given to GPs represents a complete about-turn from the Coalition Agreement of less than two months ago.

Yesterday’s announcement that all 302 152 Primary Care Trusts in England will be abolished by 2013 with more power given to GPs represents a complete about-turn from the Coalition Agreement of less than two months ago, which promised directly elected patient representatives on PCT boards and pledged that local PCTs “will act as a champion for patients”, commissioning services best undertaken at a wider level “rather than directly by GPs”.

The agreement, pages 24-25, clearly states:

We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT).

The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board. This will ensure the right balance between locally accountable individuals and technical expertise.

The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs.

It will also take responsibility for improving public health for people in their area, working closely with the local authority.

At no point does it mention their abolition, but quite the opposite, namely that PCTs would be stregthened and democartised. Now, they are in fact going to be split up between councils and GPs – yet even the supposed accountability to local councils isn’t fully democratic, as they will also be answerable to a national body.

Earlier today, Left Foot Forward looked in detail at the health secretary’s white paper, highlighting one of the most fundamental problems the plans will encounter – that most GPs do not want the hassle of strategic planning, negotiating multi-million pound budgets and making unpopular decisions about NHS service organisation and costs – and asking whether the white paper marks the beginning of the end of the NHS.

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