Primary Care Trusts

It is, to some extent. In fact, we had the same debate; some people in south Staffordshire wanted Cannock Chase primary care trust to stand on its own. There must be independent decision making; however it is up to the people of Staffordshire to ensure that points are put forward. I hope that we can build on the new, more transparent process. We must ensure that the appointment of the new chairs and chief executives is seen to be fair and based on independent professional assessment of candidates’ abilities. All too often in the national health service, it appears that people who are displaced through reorganisation, of whom there have been too many, are slotted into new jobs even when they are not very competent. It is like musical chairs without taking away the chairs. I want able candidates filling the new jobs. It is crucial, because they will be vital to leading desperately needed NHS reform. The hon. Member for Broxbourne (Mr. Walker) made the point that Ministers must ensure that the appointed people deliver on ministerial decisions, as indicated to local communities, about reconfiguration. Rumours are already circulating, possibly based on the hon. Gentleman’s experience, that some people are working to undermine those political decisions by, for instance, forcing new PCTs to share a chief executive or management board. I hope that Ministers are alert to such manoeuvres and that they stamp on them. I hope also that the Minister assures me today that no such back-door mergers will take place. I am delighted that Staffordshire Moorlands primary care trust in my constituency is already working with Newcastle-under-Lyme primary care trust, with which it will merge, to get things up and running in time for 1 October. They are moving to set up a joint professional executive committee and to fill the gaps that were inevitably and sadly left by staff moving from primary care trusts because of uncertainty over their future roles. Such collaboration, combined with the efforts of the University hospital of North Staffordshire chief executive, Antony Sumara, to mend the previously dysfunctional relationship between the hospital and the PCTs, augurs well for the future. However, we still need to get the PCTs’ commissioning function working effectively. In north Staffordshire, the new Stoke-on-Trent and North Staffordshire primary care trusts must work together more effectively, perhaps on a north Staffordshire commissioning board, to hold the acute sector to account. It is vital that PCTs are not left to sink or swim, and that best practice is shared more widely, through either a central change agency, as the Committee recommended, or a more pro-active role for strategic health authorities. Where necessary, specific support should be provided to the poorest-performing PCTs to get their commissioning role right. The Committee identified another neglected area: the changes to PCTs’ vital public health function. It was concerned that there was no consultation with public health professionals prior to the publication of ““Commissioning a Patient-Led NHS””. That is particularly worrying, as public health can be seen as an easy target when finance is tight. That was reinforced by a 2005 survey by the Faculty of Public Health that showed that there were 17 per cent. fewer public health consultants in 2005 than in 2003. It would be fine if those posts were replaced by public health posts in the community. However, having said that, 36 per cent. of PCTs in England believe that they do not have the capacity to deliver their public health programme effectively. With a new configuration of PCTs and a local engagement of clinicians with the voluntary sector and local authorities, there is a real opportunity for primary care sectors to address public health matters across artificial geographical boundaries by focusing on the problems and finding the best way of delivering public health programmes. In my own area, it would make sense for that public health remit to stretch right across north Staffordshire and bring directors of public health, consultants and particularly, community health professionals to all work together. However, with PCT deficits, there is a risk that public health will be a casualty of cost-savings. What are the Government doing to ensure that public health is kept at the forefront of local health priorities? The PCT reconfiguration has been immensely time consuming, distracting and a morale-sapping experience. PCTs have been put in limbo. Now that decisions have been made, it is vital that we focus on best practice and develop the potential of our PCTs working in local partnership. My Staffordshire PCT has been leading the way. For instance, they have been working with Sure Start, the programme for early-years youngsters. It helps to sustain a project called ““Special Matters””, a unique combination of local parents in a relatively rural area with special needs children. It meets to help steer health professionals to provide a quality and comprehensive service for all those families, not just the ones covered by Sure Start. They all have children with special needs. The project has recently won a national childcare champion award. It is unique and it is parent-led and it is activities are targeted towards the whole family. It is fantastic. However, they are doing other fantastic work using community matrons to manage patients who are at risk of emergency admission. They have reduced the emergency admissions massively. They have introduced a highly acclaimed falls programme that ensures that those people who are at risk of falls are managed in such a way as to prevent falls and to make sure that they are not admitted to hospital again. Staffordshire Moorlands PCT has the joint highest uptake of first and second measles, mumps and rubella doses by the child’s fifth birthday. It has also set up ““Physio Direct”” so that if you have back, neck, joint or muscular problems, you can use a dedicated phone line to contact a qualified physiotherapist straightaway for advice or treatment. You do not have to go through a GP.