Future shocks

Nobody should be fooled by the latest alleged concession on care
trusts.

Although the legislation will include a new clause allowing a
Health Act partnership, rather than a merger, to be imposed where a
local authority and health body are failing to work together, few
in the field take it at face value. They foresee the government
finding other ways to ensure that adult social care services are
run by care trusts.

Think back to the way in which primary care groups and primary
care trusts were introduced. Initially, the health service was told
they would not be compulsory; next there was gentle exhortation for
PCGs to become PCTs; and finally came direction. There is no reason
to believe that we will not see the same development with care
trusts.

Even if the next government does not resort to the imposition of
care trusts, it could resort to more underhand methods of achieving
of the same aim.

Ministers could devise a system whereby local authorities and
primary care trusts lose out financially if they do not form care
trusts.

The concession may quieten some protesters but it is no
guarantee that care trusts will not be imposed by other means.