PCTs will struggle with Next Stage reforms, say MPs
pharmafile | January 15, 2009 | News story | Sales and Marketing | NHS, hc, reform
Lord Darzi's forthcoming programme of NHS reforms will be hampered by PCT failings, according to MPs.
The Health Select Committee (HSC) warned poor PCT commissioning meant implementation of the Next Stage Review's proposals could be "slower and more uneven than expected".
"The ability of PCTs and SHAs to manage effectively these changes is a genuine worry," said HSC chairman and Labour MP Kevin Barron.
The HSC's report added that there were insufficient analytical and planning skills in PCTs and that variable management quality was "striking and depressing".
Chief among the Committee's concerns was the fact that variations in quality have continued despite increased funding.
The HSC believes it was neither "necessary nor sensible" to improve access to care before improving its quality.
The report drew a mixed reaction from medical groups, with the NHS Confederation insisting the Committee's fears were misplaced.
The group, which represents over 90% of NHS organisations, said the focus on commissioning presented a "very narrow view" of PCTs' capabilities.
NHS Confederation chief executive Steve Barnett said: "PCTs have strengthened their commissioning capacity significantly over the last two years and have plans in place to continue this improvement.
"With hard-won financial stability, new expertise and the world class commissioning programme, we are confident that PCTs can deliver Lord Darzi's vision for the future of the NHS," he added.
By contrast the BMA said that the Committee's report hit the mark – particularly with MPs' reservations over the Department of Health's insistence that all PCTs should have a GP-led health centre.
"Our concerns about the universal imposition of GP-led health centres are shared by the Health Select Committee," said Hamish Meldrum, BMA chairman of council.
The BMA and NHS Confederation agreed that the proposals in the Next Stage Review are short sighted.
"The Government didn't listen to the BMA's concerns as it pushed headlong into introducing a new untested way of delivering healthcare," added Meldrum.
"GP-led health centres have been introduced without proper pilots or evaluation."
Despite its criticism, the BMA says it is supportive of Next Stage Review principles, such as improving the variations in the quality of healthcare, the introduction of an NHS Constitution and the creation of NHS: Medical Education England to oversee medical training.
Clarification needed
The HSC's report called for more details to be published on a number of aspects of Lord Darzi's reforms, including their overall cost.
Neither SHAs nor government have been clear on where and how much money will be saved, it suggested.
It also wants clarification on the role of Practice-based Commissioning and says that weaknesses in NHS leadership must be urgently addressed.
Barron concluded that Lord Darzi's reforms "must not just be the latest in a series of failures to make real change".
"The Department must listen and respond to the concerns and challenges highlighted in our report."
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