This Paper from the New Local Government Network argues that Primary Care Trusts have failed to achieve local freedom and decision-making power in health, neither have they improved the health of the community. Because they receive budgets directly from the Department for Health, the ultimately financial and organisational responsibility lies with the Health Secretary. Consequently, PCT management cannot adapt fully to local conditions.The paper proposes that PCTs should be freed from central management control and national targets relaxed, in order to empower local communities to play a greater role in defining the structure and priorities of their healthcare services. This would enable PCTs to make managerial and clinical decisions that would best benefit the patients they serve, including the option to work more closely, or merge commissioning structures with local authorities. The paper does not suggest that a top-down devolutionary framework should be imposed, but that each PCT should be allowed to define its relationship with local partners and its own goals. This would create a locally-defined and locally-responsive system, which would empower local authorities and citizens to tailor goals to local needs.
The Paper is available at: http://www.nlgn.org.uk/public/wp-content/uploads/pcts_white-paper.pdf