Milburn says 'not yet' to foundation PCTs

Mental health and primary care trusts could eventually take on foundation status, according to Health Secretary Alan Milburn.

He said he was keen to examine how the acute sector foundation status model could be applied to other organisations, and would be writing to mental health trusts regarding future developments.

Many primary care leaders fear that awarding foundation status to hospitals will shift the emphasis of healthcare from a primary to secondary care setting.

Moira Britton, Chief Executive of Tees and North East Yorkshire Mental Health Trust, told the Commons Health Select Committee that f foundation status is to be provided as a means of improving care, then it should be a level playing field.

She said foundation status could prove especially useful in mental healthcare, given the challenge of providing integrated services across several PCT and local authority areas.

"It would seem to offer me the opportunity of developing much closer working relations with service users, carers and their organisations in each of the six separate localities where I work with different local authorities," she said.

The committee said the Government should examine the extension of foundation status to mental trusts "as a matter of priority".

Several PCT leaders believe PCTs represent a more natural starting point for foundation status than hospitals.

Chris Willis, Chief Executive of North Tees PCT, said the structure and organisation of PCTs, and their duty to consult and involve public a key facet of foundation status meant they had more experience of engaging local communities than acute trusts.

But Mr Milburn said it would be a "fundamental mistake' to extend the scheme to PCTs at the moment, which he said were "new young organisations that have barely begun their work."

He added that they must first develop their commissioning, negotiating and managerial skills to be in a better position to fight for their own local priorities against acute trusts

This view was shared by Mr Willis who said the current imbalance between the two was a matter of concern for PCTs. The indepdent healthcare think tank the King Fund's said: "In principal, locating purchasing power at local level makes it easier to develop community options and puts a brake on the provider power of the large acute trusts [but] in practice, PCTs are unlikely to manage to impose themselves in this way."

The committee recommended that the assessment of acute trusts' suitability to be awarded foundation status should take into account the readiness of the local PCTs who will be commissioning service from the prospective foundation trusts.