Conference told that shift to care trusts may worsen service provision

Primary care trusts working in deprived areas
are already struggling to provide core services without the
additional burden of becoming involved in care trusts, a conference
heard last week.

Gerald Wistow, director of the Nuffield
Institute for Health at Leeds University, claimed that attempting
to introduce care trusts against a backdrop of services under
pressure was “short-sighted and self-defeating”.

He told a London conference on care trusts
this week: “We do not have secure primary care services in all
areas of deprivation. Chief executives of PCTs are being pushed
into setting up care trusts by health authorities even though they
may not want to.”

Wistow added that redefining the
responsibilities of agencies involved in care trusts will lead to a
“medicalising of the care programme” and that further integration
with the NHS may result in some older people feeling isolated from
their communities.

Meanwhile, doctors leaders have warned that
health professionals “need a rest” from constant reform and cannot
cope with the upheaval involved in setting up care trusts.

Dr Michael Dixon, chairperson of the GPs’ body
NHS Alliance, said: “For the time being the NHS is suffering
exhaustion from all the changes and any further re-arrangement of
the furniture would be very detrimental to morale. The change from
PCG (primary care group) to PCT has paralysed any significant
delivery for six months,” he said.

Dixon, who is also a committee member for
mid-Devon PCT, said: “PCTs can do 90 per cent of the functions of a
care trust given an imaginative relationship between the PCT and
social services.”

Dr Dixon welcomed the 15 care trust pilots
around the country, but stressed that the initiative has to be seen
as a long-term solution to service delivery problems.

His concerns were supported by Dr Rhidian
Morris, an executive committee member of the National Association
of Primary Care, who said there were many positive aspects of local
government that the health service could learn from.

But he warned that the financial systems of
the NHS and local authorities were “almost incompatible with each

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