Primary Care Trusts

I am grateful for the opportunity to intrude on the debate as a non-member of the Select Committee. I appreciate that its report was a snapshot in time and I am sure that my hon. Friend the Minister will tell us just how far we have progressed since. Despite the passage of time and events, however, the report remains extremely topical and relevant to people’s experience in Leeds. As we know, a tablet of stone dropped from the lofty heights of Department for Health at the end of July. It contained two commandments: ““Thou shalt reduce the number of PCTs”” and ““Thou shalt divest thyself of services””. To a degree, the second commandment has been withdrawn, although how far remains the subject of debate. In my area, for example, the initial requirement for PCTs to divest themselves of services has led people to spend considerable time looking at various options, some of which would have obvious attractions to staff who wanted to avoid the threat of outsourcing. My fear is that some of those options might be pursued further out of fear and uncertainty about the future and about change, rather than primarily on the basis of what is in the best interests of patients and services. The proposals that were submitted for reconfiguration in Leeds need to be viewed in the light of the flawed top-down process that the Select Committee report so accurately described, irrespective of the Government’s emollient words in response. They were not carefully considered plans for the improvement and commissioning of services. They were an acquiescent response to the first of the commandments that I referred to a couple of minutes ago. That remains of major concern to us, because in Leeds we have generally found that the PCTs have been a success. They adopted commissioning approaches based on the needs of their communities. They have taken a particularly robust line with the local acute trust. They developed services to meet needs, very much in the way that my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) described in her area. Indeed, community services were transferred from the then community and mental health trust to the PCT as a means of improving them. In my constituency, for example, the Leeds West PCT developed a whole range of services responding to local needs, including rapid response teams to prevent unnecessary admission of older people to hospital, thereby addressing a major challenge in Leeds, which is that we hospitalise too many people and keep them there for far too long. A respiratory team has been established to advance the care of patients with certain respiratory conditions. Advanced special practitioners, who are basically senior nurses, are working with patients who have had experience of multiple hospital admissions over a year and regularly require the assistance of their GP, again to address the issue of unnecessary admission. Our profound hope is that with the reconfiguration such innovation and good practice can continue and be disseminated in a much larger PCT area. In Leeds we are talking about moving from five PCTs, the largest of which serves a population of just under 200,000, to a single PCT serving a population of more than 720,000.