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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