Doctors leaders warn that health professionals need a rest from
constant reform and cannot cope with the upheaval involved in
setting up care trusts, writes David
They also say that primary care trusts can do “90 per cent” of
the work intended for care trusts.
Dr Michael Dixon, who is chairperson of the GPs’ representative
body the NHS Alliance, said: “For the time being the NHS is
suffering change exhaustion and any further re-arrangement of the
furniture would be very detrimental to workforce morale and
“PCTs are in either in the process of formation or in their
infancy – the change from PCG (primary care group) to PCT has
paralysed any significant delivery for six months,” he said.
Dr 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
There are 15 care trust pilots around the country, and the
government wants care trusts to become the model for adult service
delivery in all areas.
Dr Dixon welcomed the pilots, but stressed that care trusts have
to be seen as a long term solution to service delivery
His concerns were supported by Dr Rhidian Morris, who is an
executive committee member of the other doctor’s body the National
Association of Primary Care, who said: “One of the problems is that
people are change weary.
“People are reluctant to dive in and care trusts are things
which will evolve rather than there being a headlong rush,” he
Dr Morris there were many positive aspects of local government
that the health service could learn from, such as accountability
for financial performance. But he warned that the financial systems
of the NHS and local authorities were “almost incompatible”.
* Meanwhile, an influential academic has warned
that primary care trusts working in deprived areas
are already facing pressure to provide core services without the
additional burden of becoming care trusts, writes
Anabel Unity Sale.
Gerald Wistow, director of the Nuffield Institute for Health at
the University of Leeds, told delegates at a conference on care
trusts: “We do not have secure, primary care services in all areas
of deprivation. Chief executives of PCTs are being distracted by
health authorities into setting up care trusts when they might not
want to. It is short-sighted and self-defeating.”
He added that redefining the responsibilities of agencies
involved in care trusts leads to a “medicalising of the care
programme”, and that a further integration with the NHS can result
in some older people feeling isolated from their communities.
Also speaking at the conference, Moira Gibb, Kensington and
Chelsea council’s director of social services, said a view existed
within the sector that the government think care trusts are the
only appropriate model and everyone will have to join the