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

  1. Mike

    You have to hand it to the Tories.
    First they secure the support of the Liberal Democrats for their right wing cuts and privatisation agenda
    then they secure GP’s to ration health care and privatise the NHS

    Burstow (Lib Dem Health Minister)is so in awe of the Tories that he said local authorities could carry out commissioning – not a hope

    Does he not understand that private health care companies and big business are already using the word de nationalisation of the NHS.

    Private health insurance companies will offer to do the commisioning for free to secure access to patients

    These GP consortia will end up employing Gps just like American Health Maintance Organisations (HMOs)

    The bottom line is GPs will be rationing care

  2. Mr. Sensible

    Oh yes, I’d forgotten that.

  3. Sean

    So it falls to the Liberal Democrats to privatise the NHS

    hope they choke

  4. Anon E Mouse

    Scrapping PCT’s – Thank god for that. Not before time. My elder daughter works for a dental practice with over 75% NHS patients and she said it couldn’t come soon enough.

    This government gets better and better by the day. Imagine the idea that the care providers are trusted to care for their patients in their way!

    Great news – I’m voting Lib Dem next time…

  5. Jill

    strange as Lib Dems wanted PCTs should be the central plank of the NHS ?? and democratically elected

    so scrapping it is a Tory victory

    so vote for the Tories as you did last time

    By the way didnt the Tories Privatisatise Dental Services

    that worked well

    few NHS dentists

    and very rich dentists
    and low paid dental nurses

  6. Rachel Hardy

    PCTs: From being "champions for patients" to being abolished – in just two months | Left Foot Forward http://goo.gl/mivh

  7. Anon E Mouse

    Jill – I’ve never voted Tory, usually Labour but once Lib Dems tactically to get rid of the Tory MP and last time Independent.

    The fact is this country run by the Labour Party was a disaster and their quangos and the like such as public servants becoming millionaires stinks.

    Couple that with the Labour Party’s love of big business, foreign conflicts, slavish support for right wing US administrations, hammering the poor with excessive taxes, state surveillance, HIP’s, bin tax etc and just general incompetence means I’m with the Lib Dems now their stupid policies such as wishing to scrap Trident have been tempered by the Tories.

    The fact is Labour is a busted flush – reading Mandelson’s memoirs in Times tells you everything about (current incarnation) the party.

    If Labour supporting zombies had actually listed to critics like me and decent Labour MP’s (Frank Field, John Reid types) and had the guts to act they wouldn’t have had to shuffle, open mouthed into a booth to vote Labour on May 6th.

    The last Tory government was 13 years ago. Keep harking on about the past will increase Labour’s time in opposition…

  8. Mike C

    Firstly, despite this man’s (Andrew Lansley) best beliefs he doesn’t have the capability to radically redesign NHS provision in such a way all by himself. Nor do the government and its advisors. There needs to national consultation.

    Secondly, the GPs don’t have the capability to run and manage the provision either.

    Thirdly, there is no mandate for this change. Lansley’s white paper is a clear election promise break.

    Finally, the NHS is unable to carry out such a change whilst still finding 20 billion of savings.

    I really have to question the gall and sanity of a party which believes it can pull such a radical change out of the hat so soon after being elected with a minority.

  9. Chris


    Yawn, astroturfing trolls are so boring especially when they put absolutely no effort into it. I mean your post reads like a list of talking points for tabloid interviews and on what fucking planet could Field be called a decent Labour MP, he may be a decent MP but never a Labour one.

    Whose hand is up your ass, sockpuppet? A LibDem or maybe your really one of Grant Shapps creations – http://bit.ly/15xsj5

  10. Gerry

    Mouse have you ever thought what will happen to your daughters employment as a dental nurse when they scrap the local PCT ?????

    What do you think will happen ????

    Well I will tell you

    the contract/ commissioning of NHS dental services will be given to local GPs

    who will, based on previous experience either give it to the cheapest tender or a multinational dentist chain

    bye bye little dentist (unless you have a majority of private patients)

    so if your daughter is in a practice with 75% NHS dental patients

    she will need to find a new job soon

  11. Chris WashingtonSare

    RT @leftfootfwd: Primary Care Trusts to be abolished in the UK. http://goo.gl/mivh > Thatcherism creeps back

  12. Anon E Mouse

    Chris – Funny isn’t it that (aside from resorting to the foul language in public) you immediately dismiss decent Labour MP’s and thinkers such as Charles Clarke etc who aren’t tribal and put the public before their own political ambition.

    After my whole family have voted Labour our whole life – and I mean Labour not your version of some party where the class warrior John Prescott plays croquet on the lawn or a countesses niece , Harriet Harman id deputy leader – we certainly won’t be again.

    From your childish post I feel safe to assume that you are considerably younger than me and may I suggest at your next student debating society meeting you ask why Frank Field was wrong to suggest removing the 10p tax rate would hurt the poor.

    Remind me how Gordon Brown could state that taking more money from the poorest in our society would raise their economic circumstances please.

    (Not that you would be familiar in anyway with the more disadvantaged in our society Chris I’d like to bet…)

  13. Liz McShane

    Anon – I think you can rest assured that voting Lib Dem (at least if led by Clegg) will get you a Tory Government & policies.

  14. Anon E Mouse

    Liz McShane – Tory government? Are you mad woman!

    Since when (under Ken Clarke) did the Tories say “Prison isn’t working” or advocate a banking tax (agreed on by the European Union)?

    You can’t tell me this doesn’t feel different and the Lib Dems are in government now Liz – they can make a difference unlike that last useless bunch.

    Oh and as you know the things that you and others challenged me on in this fine blog have been proven right in my case – read what Peter Mandelson says in his book. I was right about the sad state of Labour and still am.

    I won’t gloat but it is nice to be proven right and hordes of others here who called me numerous offensive things may wish to now retract what they said…

  15. Dave

    I am not sure what the Tories expect to achieve with abolishing PCTs and SHA’s, sure they expect to save money on management costs, but have they considered that the management is actually needed.

    Firstly, 99% of GP practices are private organisations. They are not NHS empolyees they merely hold an NHS contract. Therefore why is the government planning to give control of multi million pound contracts (public money) to private business men and women.

    Secondly, how are GP’s going to commission the vast array or services needed to meet the needs of local populations? They will need to buy in help, which they could do from private organisations. Probably organisations said GP’s have some stake in. Conflict of interest, I would say so. Also these companies providing commissioning advice need to turn a profit, therefore there will be a cost. Considering PCT’s have been doing this job for years, surely they are better placed to act as commmissioners? I would also put good odds on the private companies who are willing to sell commissioning advice are also providers of care services, another conflict? Yes, of course it is.

    Thirdly, the government is asking PCT’s to ensure they work effectively until a hand over in two years time whilst trying to save £20billion in efficiency savings. So for two years, PCT’s will be making their own coffin, reality – not going to happen.

    The whole paper appears to have hardly been thought through, consultation – well that appears to have been just talking to a handfull of GP’s, the said GP’s who will benefit from the changes.

    Did anyone see there recent Nuffield report, showing less than 20% of GP practices actually manage their budget effectively, can you imagine giving them billions?

    Will this work? Who knows, however the evidence so far suggest there is alot more work to do.

  16. Liz McShane

    Anon – you can’t deny that The Lib Dems have jettisoned a lot of key policies & principles (that’s if they ever had any) now that they are ‘in bed’ with The Tories. Surely you can’t deny that? eg VAT increase? But Clegg was alwaya a bit of a ‘closet Tory’ anyway.

  17. Liz McShane

    Anon – p.s. have you found the source yet of that very ‘interesting’ statistic you mentioned yesterday that shows that 90% of The UK population want the death penalty back…?..

  18. Anon E Mouse

    Liz – The 90% was in a News Of The World survey several years ago so no but Tony Blair once mentioned it I think!

    I actually think it’s probably more now since Ian Huntley butchered those little girls a few years back.

    Clegg always was a Tory I agree; there never was a closet! and yes in a coalition it is a matter of give and take.

    Remember Liz it’s the new politics and we’re all in this together…

  19. Liz McShane

    Re the NOTW survey – I wonder what the question was….?

    Re this coalition – so far it seems to have been more ‘take’ (from Tories that is).

    ‘We are all in this together’… God help us!

  20. Mike

    The Tories dont care if GPs want to commission services

    they will force it through

    But Norwich Union or what ever they are called now ….Aviva

    will do commssioning for free …anyway

    just to get access to patients and offer them “top up” private health insurance

    or to jump the long queue’s the Tories will have in the NHS due to cuts

  21. Anon E Mouse

    Liz – How about the £10k tax level – that was Lib Dem. There was a time when the Labour Party used to represent the poor you know…

    Have you actually read the coalition agreement?

  22. joe fd

    Just for accuracy’s sake there are 152 PCTs, not 302.

  23. Terry

    Lib Dem Voice

    says Lib Dem input into NHS white paper is Local authority overview of GP commsissioning

    Yet Local authorities already have this power to review NHS plans – O & S committee

    So this was there fig leaf they got for agreeing to privatise the NHS

  24. Liz McShane

    Anon – I was referring the The Lib Dem manifesto which is what people who voted LD voted for. The Coalition Agreement was just between The Tories & Lib Dems and not voted on by the electorate!

  25. Anon E Mouse

    Liz – Everything changed once the size of the Labour debt was uncovered – the last Labour treasury minister admitted it.

    I remember “No tuition fees” and “Lisbon Treaty referendum” and “Full third term” and on and on.

    The coalition agreement may not have been voted for but Labour most certainly were not (according to every minister in the leadership election)and it seems for reasons I have been ranting about for ever… your beloved Gordon Brown… not that ANYONE ever elected him as Prime Minister.

    Or Labour leader…

    It doesn’t matter who you vote for the government always gets in!

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