Primary Care Trusts

I welcome the Minister and I congratulate him on his position. He was not merely an adornment to the Health Committee when he was a member of it; he was a hard-working and effective colleague, and stories of his exploits abroad are certainly well worth listening to. Much has been made of the letter of 28 July. I simply say to the House that it was not received particularly well, whatever the reasons for it and whatever the timing of its publication. The last time that the Secretary of State for Health came and gave evidence to our Committee, she was surrounded by people who were acting in their posts. And, of course, Sir Nigel Crisp—the architect of the letter—is no longer with us. To cut to the chase, there is no doubt at all that the whole exercise was embarked upon to save money—though we can argue about how much was actually saved. As my hon. Friend the Member for Wyre Forest (Dr. Richard Taylor) said, there were undoubtedly some political shenanigans going on the background—shenanigans that had mixed success. ““Commissioning a patient-led NHS””, the document published by the Government on 28 July 2005, set out the Government’s proposals to reconfigure the current 302 primary care trusts to 152 larger organisations, with—we were told—cost savings of up to £250 million. I hope that the Public Accounts Committee will report in due course on exactly how much money is saved on that little bit of nonsense. The then chief medical officer outlined how the changes would improve and strengthen the commissioning function of PCTs and divest their provider role in areas such as community health service to the non-provider NHS. The Health Committee report on changes to PCTs acknowledges that, as has been said, the reforms are necessary. However, it highlights several key concerns on which I shall dwell, particularly the concerns about the way in which the consultation on the Government’s proposals was conducted. As all hon. Members, or certainly those on the Opposition Benches, know, these so-called consultation exercises are becoming utterly meaningless. I also wish to touch on how the proposals will affect local health service delivery and public health, which are crucial. It would be nice for each of us, when we are no longer Members of Parliament, to have a quotation by which we will be remembered. We are always quoting the remarks of famous political figures. In April 1999, when I was a member of the Standing Committee—I believe that it was in this room—on the Health Bill that abolished GP fundholding to create PCTs, I said that it was a ““truly socialist Bill.”” It was legislation that was intended to centralise health care provision commissioning away from clinical professionals and towards central Government. The reconfiguration of PCTs will take centralisation one step further through the creation of fewer and larger PCTs. For example, we in Essex have 13 PCTs, but later this year we will have five. Among Essex MPs there is great concern about that.