Primary Care Trusts

My right hon. Friend is making a powerful case. I recognise the pressures that he described, but does he agree that the impact of the reform process on individual PCTs is to some extent dependant on the way in which those PCTs are managed? An effective PCT is much better able to respond to the opportunities of change. In Swindon, we have an effective, well managed PCT that has taken advantage of the changes that the Government are driving forward to look at innovative ways of servicing delivery. That is driven not primarily by financial considerations, as my right hon. Friend said, but, for example, by integrating the work of the PCT with social services and housing services to provide a total care provision that is imaginative and will significantly improve what we can offer to the people of Swindon. That is possible only because of the managerial competence of that PCT.