Remind me again, why is the Secretary of State abolishing PCTs?
Filed Under (Clinical Commissioning Groups, Primary Care Trusts, Secretary of State) by Paul on 07-11-2011
Last week I spoke at the National Association of Primary Care Conference and was interested to hear the Secretary of State. As I shall explain tomorrow it was good to hear him articulate a narrative explaining why his reforms were important to an audience of future leaders of Clinical Commissioning Groups. (Even if that narrative failed to encompass the real life experiences of creating CCGs that those in the room expressed to him).
What interested me most was the way in which he talked about the nature of the commissioning support that CCGs would need as and when they become authorised.
His theoretical position was that the ‘CCGs would be free to employ whomever they wanted to provide them with support’. (Which I think must be the legal position of any authorised CCG.) However there is some distance between the actual exercising of that freedom in the future, and where we are today.
Having expressed his belief in their freedom he then said, to an audience that he knew would be leading future CCGs, that there were very good people with the right skills that CCGs needed now working in PCT clusters. – You will want to ‘build on relationships with existing colleagues’. You will recognise that ‘these skills can be found in PCTs’
In this passage of his speech he recommended PCT staff to CCGs on four separate occasions.
Later on, in the panel, I said that I hoped he was getting some agency fees for such a fervent set of recommendations. At the very least, whenever a CCG used an ex-PCT member of staff to work for them, the Secretary of State should get a 10% fee for the introduction.
Then it was pointed out to me why he was doing this. He desperately wants CCGs to employ ex-PCT staff, because if they don’t he will have to pay their redundancy costs. And if those costs come into the budget in 2012/13 it will increase the cost of these reforms by a much greater sum than he has predicted.
So the Secretary of State’s revolutionary reform programme has been reduced to him going around the country recommending that CCGs take on ex-PCT staff to avoid them adding to his redundancy costs.
This felt bad enough. But a much bigger, more desperate thought came to me.
In July 2010 weren’t PCTs just a bunch of bureaucrats that were getting in the way of decent commissioning?
Yet just 18 months later these same people have the skills to ensure that good commissioning can take place.
The thought crept over me that if PCT staff are so good that the Secretary of State is recommending their skills to future CCGs, why has he gone to all the trouble of abolishing them?
If the same people will be doing the same jobs – has it all been worth it?
The only objective behind the reforms is an ideologically driven desire to increase private interests in the delivery of health care, despite the acres of evidence that it increases costs wiout improving population health outcomes. They want to screw down wages but allow big pharma & the companies that produce medical equipment to feast on the system. Patient care is not the priority. So none of this should be a surprise.
[...] Corrigan was at an NHS conference last week, during which Andrew Lansley tried to persuade the new Clinical Commissioning Groups to take on [...]
SOS speech reflects an unresolved ideological split at the heart of the DH. Read the assignement policy issued March 2011. http://www.socialpartnershipforum.org/SiteCollectionDocuments/Assignment%20for%20Transition%20Guidance.pdf
It’s not just redundancy claims that PCTs would face. You cannot rewrite the law on TUPE through a policy declaration. If PCT functions transfer to CCGs then so do staff and it is the CCGs that inherit the liability for redundancy or unfair dismissal payments. The penny has finally dropped!
So a brilliant strategy then. TUPE transfer rights and large redundancy payments to achieve what? the mother of all postcode lotteries in healthcare provision as the “N” in NHS is replaced by “Local” – LHS.
In answer to your final question: No
Wasn’t his thought process along the lines of:
PCTs: Management staff > GPs
CCGs: GPs > Management staff
The question is, could a more difficult route from PCTs to CCGs have been devised? I doubt it.
Actually, it may well be that PCTs do have among their staff some who would be very valuable to employ. It may just be that these institutions as a whole are malfunctioning and/or that a substantial number of the managers employed there are counterproductive or sub-productive.