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Answers to Parliamentary Questions

PRIMARY CARE TRUSTS (PCTs) AND SPECIALISED TREATMENTS

Baroness Masham of Ilton asked Her Majesty’s Government:

How the new arrangements for commissioning of specialised treatments in the National Health Service are functioning.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, all primary care trusts are now actively involved in one of the 26 local specialised commissioning groups set up across the country. As members of these groups, PCTs work together to commission specialised services. This year’s work programme for each commissioning group demonstrates that a substantial number of specialised services are now being planned collectively. For certain specialised services where the financial risks are high, collective funding arrangements are in place, including financial risk-sharing between PCTs.

Baroness Masham of Ilton: My Lords, I thank the Minister for that reply. Is he aware that the Specialised Healthcare Alliance and the Royal College of Physicians are concerned that while some PCTs are doing their job well, others are inadequate? Does he agree that postcode prescribing for specialised services is unacceptable, when it can be a matter of life and death, and of quality of life for patients?

Lord Warner: My Lords, I am aware of the survey that the noble Baroness mentioned, although I have not read it, because I understand that it is still in draft form. We welcome the broad findings of that survey, which was carried out by the Specialised Healthcare Alliance. It shows that a good start has been made by PCTs to work together to commission specialised services. It makes the point that a number of improvements can be made. We shall be looking at those suggestions carefully, and we hope to respond to them positively. The Government have made clear our position on postcode prescribing, and we are taking action to try to improve the implementation of NICE guidance in that area.

Lord Ashley of Stoke: My Lords, is my noble friend aware that the Audit Commission and the Commission for Health Improvement have both said that some primary care trusts lack management capacity, basic information and the capacity to monitor their output? In view of these well informed comments, would the best way forward not be to focus on improving these aspects of the work of the primary care trusts?

Lord Warner: My Lords, I recognise the points made by my noble friend, but as my Answer made clear, we have made big steps forward since the Government issued guidance in March 2003 in the area of specialised commissioning. I accepted, in response to the supplementary question asked by the noble Baroness, Lady Masham, that improvements could be made that have come out of the survey. We will be taking those forward. I do not accept, however, that PCTs are not working together now to improve the way in which they collectively commission specialised services.