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NHS reforms may threaten public health initiatives and fragment community services without making the 250m savings expected.

MPs were told that the drive to save money and reduce primary care trust deficits could divert funding.

Dr Tim Crayford, of the Association of Directors of Public Health, said: "Public health initiatives take years to bear fruit and are very easy targets for cuts."

He was giving evidence to the health select committee's inquiry into the government's plans to restructure PCTs.


Despite witnesses saying that savings appeared the key driver for the reforms, there were doubts that the 250m target would be achieved.

Karen Rhodes, director of primary and community care at North Lincolnshire PCT, said savings from having fewer, larger organisations would have to be reinvested to set up area-based arrangements to maintain local engagement.

It was also claimed that the government's call for new providers to take on PCT functions would fragment community health services.


Lynn Young, primary care adviser at the Royal College of Nursing, said: "If you have a lot of providers doing discrete parts of the system how are you going to get the seamless services for people whose needs go across [the system]?"

But health minister Lord Warner said that although PCTs would inevitably provide fewer services, decisions on how this would happen would be taken locally.