Primary Care Trusts (Hansard, 4 July 2002)

§ Lord Ashley of Stoke
asked Her Majesty's Government:
Whether the transfer of powers from health authorities to primary care trusts has been satisfactorily completed.

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, on 1st April 2002, 139 new primary care trusts were established, to make a total of 303. There was only one remaining primary care group at that time. The transfer of functions from health authorities to primary care trusts is well under way and early indications are that primary care trusts are progressing well.

§ Baroness Finlay of Llandaff
My Lords—

§ Lord Ashley of Stoke
My Lords, I thank my noble friend for that reply. I welcome warmly the Government's very radical reorganisation and transfer of powers to primary care trusts because that will certainly reduce the bureaucracy involved in dealing with sick and disabled people. However, because the trusts are inexperienced, is there not a danger that they may deal exclusively with high-profile illnesses and disabilities and neglect the relatively unpopular conditions? Will my noble friend use performance indicators to ensure that that does not happen? Will he further seek to ensure that, as best he can, he will give general guidance to the PCTs on the points that I have raised?

§ Lord Hunt of Kings Heath
My Lords, on the question of performance indicators, the first set are due to be published later this year. It is clear that we need to strike a balance in this area. The whole point of devolving authority to primary care trusts is to ensure that GPs and other primary care staff have a much greater input into key decision-making. In many ways that is the best answer to the questions put by my noble friend. GPs experience the sicknesses of many patients day in, day out. I believe that the commissioning decisions reached by PCTs will be best informed by the experience of GPs. However, of course we shall ensure that if, through commissioning decisions, services are being missed out, we have a performance management regime to enable us to intervene where we have to do so.

§ Lord Clement-Jones
My Lords, the Secretary of State has pledged that primary care trusts will be responsible for dispensing 75 per cent of the health service budget. When will that become a reality?

§ Lord Hunt of Kings Heath
My Lords, we are aiming for that to take place in 2004.

§ Lord Walton of Detchant
My Lords, is the Minister satisfied that the transfer of authority and funding from health authorities to primary care trusts is preserving adequately the needs of tertiary and highly specialised treatments in our hospitals? Furthermore, is he satisfied that the problems related to teaching and research are being properly addressed now that we are increasing the number of medical students being admitted to our medical schools?

§ Lord Hunt of Kings Heath
My Lords, I very much accept the point made by the noble Lord on the question of specialised commissioning. We do expect some primary care trusts to take a leading role in their health communities, but we also have in place national specialist commissioning arrangements.
With regard to teaching and research, it is in the interests of everyone working in the National Health Service to support those activities. We shall not get the high-quality doctors, nurses and other staff we need unless we do so. I fully expect primary care trusts to support teaching and research programmes. The noble Lord will know that we have agreed to a joint review to be conducted by ourselves and the DfES to look at those aspects which are presently causing concern.

§ The Lord Bishop of Portsmouth
My Lords, the noble Lord's Question concerns local out-workings in the context of shifting responsibilities. Will the Minister comment on what many people in Portsmouth see as a disastrous scenario—that is, the possible closure of the Haslar hospital in Gosport and the redevelopment of the Queen Alexandra hospital in Cosham on an already over-crowded site with 346 sometimes chronic traffic problems in the vicinity? In the words of the noble Earl, Lord Russell, a veritable expedition to the North Pole.

§ Lord Hunt of Kings Heath
My Lords, I am grateful to the right reverend Prelate for raising the issue, which I know he feels keenly. The whole point of what we are trying to do with primary care trusts is to decentralise decisions down to local level. Within Portsmouth the local primary care trust will have much more influence in the future, informed by the experience by general practitioners, who are in turn informed by what patients think. So far as concerns the specific issue, we shall look very carefully at the points raised by the right reverend Prelate.

§ Baroness Pitkeathley
My Lords, does my noble friend agree that primary care trusts, with their welcome emphasis on patient and public involvement, will be well placed to monitor all the health needs of the communities they serve, including what my noble friend calls the "unpopular" ones? What are the Government's plans for evaluating and disseminating the information collected by PCTs?

§ Lord Hunt of Kings Heath
My Lords, I agree with my noble friend. Primary care trusts will be helped by the enhanced arrangements for public and patient involvement in decisions at the local level through the creation of patients forums. As regards information about good practice, we are committed to a large programme of dissemination of such information. Primary care trusts will be fully a part of that programme.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware—

§ Lord Taverne
My Lords—

§ Baroness Gardner of Parkes
My Lords, the Liberal Democrats have asked one question; we have not. Is the Minister aware that every reorganisation involves some redundancies because people find themselves in positions for which they are no longer suitable? When the GPs changed to primary trusts, a good deal of expense was involved in meeting redundancy costs. Who will be responsible for meeting these costs if the same situation arises? Has this part of the operation been adequately funded?

§ Lord Hunt of Kings Heath
My Lords, we have made available more than £60 million to support the establishment of primary care trusts. Responsibility for staff redundancies will be transferred to the relevant authority. That is no different from any other reorganisation. Since we came into office in 1997 we have made great strides towards reducing the amount of money spent on bureaucracy—but not, I hasten to add, at the expense of investing in high quality management. I draw a distinction between the two.

§ Lord Taverne
My Lords, I declare an interest as chairman of a trust concerned with the treatment of 347 drug addicts. Is the Minister aware that the transfer of funding to primary care trusts has caused chaos in the payments to many charities, which is causing extreme financial embarrassment to some. These charities are very much concerned in dealing with one of our most pressing social problems. Will the Minister look at this issue?

§ Lord Hunt of Kings Heath
My Lords, I am sorry to hear that. I shall be very happy to investigate. I am very keen to see stability in the funding and support by the health service of voluntary organisations in order that they may know what is likely to be their funding, not only for a year ahead but for a longer period. That is entirely consistent with the long-term spending review for the health service that we have already announced.

§ Baroness Finlay of Llandaff
My Lords, I apologise for my untimely and inappropriately early intervention. Have those in primary care trusts been adequately trained to fulfil their function of ensuring equity in the monitoring of uniformly high standards, especially in relation to the care and protection of children and the care of the vulnerable and elderly?

§ Lord Hunt of Kings Heath
My Lords, the answer is yes. While ensuring that there is a uniform provision of service throughout the NHS, we must also ensure that primary care trusts have sufficient flexibility to make their own decisions in the light of local circumstances.