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LETTERS: Hilary G Pickles Turning round NHS deficits: ...is more difficult for PCTs BMJ 2006; 332: 363 [Full text]

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Deficits in PCTs damage Public Health work

Jeremy P Wight   (15 February 2006)

Deficits in PCTs damage Public Health work 15 February 2006
Jeremy P Wight, Director of Public Health North Sheffield Primary Care Trust, S5 6NU Send response to journal: Re: Deficits in PCTs damage Public Health work	Hilary Pickles is absolutely right in highlighting the particular difficulties involved in turning round financial deficits in PCTs. These are particularly exacerbated for those trusts that commission largely from Foundation Trusts, for whom the earlier introduction of the 'Payment By Results' regime has effectively meant that we no longer have any real control over the amount of expenditure on secondary care (since the money has to follow the patient, and it is other people who decide where the patients go, and how many of them). However PCTs do still have control over Public Health budgets, and when they face large deficits it is inevitable that these are turned to first as a source of savings. Though this may be attractive as a means to help short term financial balance, it is misguided in the longer term, because public health spending is part of the solution, not part of the problem. Jeremy Wight Competing interests: None declared