Select Committee on Health First Special Report

Primary Care Groups

SESSION 1998-99
Health Committee Recommendations: Progress - Primary Care Groups

Second Report: Primary Care Groups (HC 153) Published: 03/02/99

Government Reply: Cm 4468 Published: 10/99


Government Response and Action

We recommend that more guidance is issued as quickly as possible and in a co-ordinated fashion in areas such as data collection which are essential to the smooth running of the project. We also recommend that DoH closely monitors the progress of PCGs and issues regular reports on this to the Committee. (Paragraph ?)

Has done so

We recommend that the composition of PCGs, their mechanisms and budgets should not be regarded as set in stone and should be kept under review. (Paragraph ?)

Broadly accepts

We welcome the fact that the DoH wishes the momentum towards PCT status to emerge from the Groups themselves, rather than by virtue of Government intervention. We recommend that this should be the case for moves between each level. We also recommend that PCTs are not established unless their Board membership has been reviewed to ensure it reflects the broader professional and community input that is required for PCT status. Serious concerns have been expressed about the potential conflict of interest in having a built-in majority of provider GPs on PCT Boards. We recommend that DoH gives this matter careful consideration before PCTs are established. (Paragraph ?)


Trusts will have lay majority on Boards and professional majority on Trust Executives

We recommend that DoH keeps under review the cover arrangements in place for shadow PCG Boards in order to establish the extent of problems (if any exist). We also recommend that the impact of the establishment of PCGs on the numbers and types of staff needed and on the staffing budget is carefully reviewed by DoH. (Paragraph ?)

Acknowledges heavy workload in shadow stage

Recognises need to strengthen GP workforce

We recommend that the process for agreeing budgets between PCGs and HAs is transparent in order to minimise complaints that PCGs with similar levels of responsibility are receiving widely different amounts from the HA. We recommend that the DoH reviews carefully the allocations to the smaller PCGs to ensure that they are not disadvantaged by having larger overheads per capita of population served. (Paragraph ?)

Will collect and make available data on allocation of management resources. Regional Offices will discuss anomalies in funding with health authorities

We recommend that the DoH establishes procedures early on to assess the actual efficiency gains from the reforms to ensure maximum value for money. (Paragraph ?)

Costs must be contained; new performance framework will move focus away from finance and efficiency; has commissioned research into PCGs

We recommend that the Government monitors the management of PCGs and makes available training for members of PCG Boards (particularly those with no experience of fund-holding) to enable them to manage budgets competently. (Paragraph ?)

Is doing

We believe it is vital that PCG performance is regularly monitored and guidance and good practice is distributed. (Paragraph ?)

Database is being developed to enable PCGs to learn directly from each other

We recommend that DoH spreads good practice on effective ways of involving the community in PCGs. (Paragraph ?)

see above

We recommend that a high priority is placed on the education and training of primary care professionals and that effective mechanisms are put in place to deal with poor performance. (Paragraph ?)

Accepts. Training steering group has been established. A Consultation document will be published on dealing with poor performance

We recommend that DoH ensures the widespread dissemination of innovation across the country. We recommend that DoH puts mechanisms in place to deal with potential conflicts of interest and reassure GPs that their clinical freedom to practice effective evidence-based healthcare has not been curtailed. (Paragraph ?)

see paras 14 & 15

We recommend that there should be clarification of the accountability of the social services Board member to the LA and HA. (Paragraph 21)

SSD officer on PCG board remains an employee of local authority. Guidance has been issued

We recommend that DoH provides guidance to PCGs on obtaining public health expertise from HAs and LAs, local universities and medical schools. (Paragraph ?)

Has done so

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