Directors accuse government of snub over NHS restructuring plans

Social services directors have criticised the Department of
Health for shutting them out of plans to restructure the NHS
despite the significant implications of the plans for councils.

Association of Directors of Social Services said it was given no
prior briefings on proposals, published in July, to slash the
number of primary care trusts.

President Tony Hunter said: “We have forums in place where these
sorts of issues can be discussed because sometimes they have
unintended consequences as is the case with this initiative.”

He cited the likelihood that smaller PCTs would be merged,
despite the fact that many share the same boundaries as, and have
strong links with, councils.

Hunter added: “They may have joint posts and pooled budgets in
place, which would need unravelling [as a result].”

The problem stems from the tensions between two objectives in
the DH’s Commissioning a Patient-Led NHS: making 15 per cent
savings from restructuring PCTs, and improving co-ordination
between social services and PCTs by aligning boundaries.

While mergers in rural areas, where there are typically many
PCTs to each council, could lead to alignment, this is not the case
elsewhere, where smaller trusts and councils are more

Jeff Jerome, co-chair of the ADSS disabilities committee, said:
“It would have been good to have some kind of discussion beforehand
to put a local government perspective on it because I don’t think
it’s there in the proposals.” He also attacked the rapid timetable
for reform. Strategic health authorities, which manage the
performance of PCTs, have been given until 15 October to put
forward proposals for restructuring trusts.

A DH spokesperson said Commissioning a Patient-Led NHS contained
nothing new in policy terms. All of it drew on last June’s NHS
Improvement Plan and its successor, Creating a Patient-Led NHS,
published in March, both of which had been consulted on, she

However, Hunter said: “There are real implementation issues
which we feel haven’t received the full attention they need.”

He hoped the matter would be discussed at next month’s meeting
of the social care forum, the DH’s new body for consulting the


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