Primary care trusts

doi:10.1136/bmj.329.7471.871

BMJ 2004;329:871-872 (16 October), doi:10.1136/bmj.329.7471.871

Editorial

Primary care trusts

Premature reorganisation, with mergers, may be harmful

The first 150 words of the full text of this article appear below.

Just over two years ago, in a reorganisation of the NHS in England,303 primary care trusts were created, each with responsibilityfor providing primary health care, improving health, and commissioningsecondary care services for a population of around 180 000.With about 80% of NHS funding flowing directly to primary caretrusts on a capitation based formula, hopes were high that thesenew organisations would be powerful agents for change in a moredevolved, clinically driven, and locally responsive NHS.¹

Some in the NHS, however, believe that primary care trusts havefailed to fulfil these expectations. There is a growing beliefthat many trusts are perhaps ineffective organisations—tooweak to stand up to providers of acute care in tough negotiationson commissioning and too small to fulfil their public healthresponsibilities. Some would argue that they have so far beenunable to establish strong and credible management teams.²

The . . . [Full text of this article]

Kieran Walshe, professor of health policy and management

University of Manchester, Manchester M13 9PL (kieran.walshe@man.ac.uk)

Judith Smith, senior lecturer

University of Birmingham, Birmingham B15 2RT

Jennifer Dixon, director of health policy

King's Fund, London W1G 0AN

Nigel Edwards, director of policy

NHS Confederation, 1 Warwick Row, London SW1E 5ER

David J Hunter, professor of health policy and management

Wolfson Research Institute, University of Durham, Queen's Campus, Thornaby, Stockton on Tees TS17 6BH

Nicholas Mays, professor of health policy

London School of Hygiene and Tropical Medicine, London WC1E 7HT

Charles Normand, Edward Kennedy professor of health policy and management

Trinity College Dublin, 3-4 Foster Place, Dublin 2

Ray Robinson, professor of health policy

London School of Economics and Political Science, London WC2A 2AE

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Rapid Responses:

Read all Rapid Responses

Here we go again: Sergio A Battistessa
bmj.com, 15 Oct 2004 [Full text]
A bigger picture: Keith J Edgar
bmj.com, 16 Oct 2004 [Full text]
The Primary Care Trust - an inappropriate body to fund secondary care: Nicholas M Wilson
bmj.com, 17 Oct 2004 [Full text]
Its the complexity, stupid!: Steven Ford
bmj.com, 18 Oct 2004 [Full text]
Primary care trusts are a flawed model for service integration: Laurence A Malcolm
bmj.com, 18 Oct 2004 [Full text]
Whatever happened to evidence-based policy?: Marcus J Longley
bmj.com, 18 Oct 2004 [Full text]
We need to be prepared to expect and accept the inevitable: Padmanabhan Badrinath
bmj.com, 18 Oct 2004 [Full text]
Victims or benificiaries?: Andrew J Wall
bmj.com, 19 Oct 2004 [Full text]
Zen Buddhism in the NHS: Stephen f Hayes
bmj.com, 19 Oct 2004 [Full text]
After wars and fox hunting - it must be healthcare: David A R de Berker
bmj.com, 20 Oct 2004 [Full text]
Re: Zen Buddhism in the NHS: Peter Morrell
bmj.com, 21 Oct 2004 [Full text]
Mergers should not be delayed: Richard M Vautrey
bmj.com, 22 Oct 2004 [Full text]
Vaguely right is better than precisely wrong: David P Kernick
bmj.com, 29 Oct 2004 [Full text]