Primary Care Trusts

May I first welcome the Under-Secretary of State for Health, my hon. Friend the Member for Bury, South (Mr. Lewis). This is his first debate as a Minister in the Department of Health in which I have taken part. Clearly, he will be able to throw up his hands in the air later and say, ““It was nothing to do with me, guv””, as most of the issues before us this afternoon predate his entry into the Department. I thank members of the Health Committee who are here today for taking evidence and for drawing up the report. I am the chair of the Committee, which has been doing good work over many years. The report was instigated effectively by the Department’s letter on 28 July about both the reconfiguration of primary care trusts and strategic health authorities as well as the issue of providing and commissioning at local level. That matter, to which I shall return, was not something into which the Committee went in great detail and made recommendations about; we did not examine all the aspects of the letter of 28 July, but clearly looked into some implications of changing primary care trusts from being providers of services to commissioners of services. That was set out in the original letter of 28 July, which was entitled ““Commissioning a patient-led NHS””, on which I shall comment later. Some of our criticisms of the letter and the subsequent debate were sharp in tone and quite deliberate. The English language, on which I am not the greatest expert in the world, can draw attention to different matters just by the use of the right types of words in reports. The Government thought that some of what we said was a little over the top. In one of our recommendations, we said that the reforms were poorly conceived, rushed and badly implemented, that there was no clear evidence base for them and that the consultation process was inadequate. The Government defended themselves. We put in the report that they had developed the reforms on the hoof, in response to which they said that that was not the case. They stressed that strategic health authorities had been asked to engage with local partners in developing proposals prior to a 14-week formal consultation period. The essence of the letter of 28 July was interesting. I will not go into the detail of our report, but the information in the letter had been sent out earlier in the year—in March, I think—by the Department when asking for responses from PCTs and the SHAs. Of course, we all know what happened soon after March 2005; a general election was called and, as a consequence, I suspect that one or two feet went up on the table on the basis of, ““We don’t know whether what is wanted of us now will be what is wanted of us by the next Government after the general election or, indeed, the next Minister if the Government change their politics.”” We found that, because of the general election, matters slowed down; the letter of 28 July came at the beginning of the recess and there were consequent feelings by hon. Members and those outside the House that the proposals had come far too quickly. There are probably lessons to be learned for all of us, in the sense that the civil service reacts to events and, when we go into general election mode, it generally slows down a little until it knows where we are at.