Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 280 - 281)



  280. Do you think that because of the kind of erosion of some of these boundaries, we might see changes in practice?
  (Ms Harding) We could well do so, because I think it is people on the ground in the front line who can see what are the consequences of not providing those community health services or those GP services. I agree very much with Diana that the fact that there will be greater patient and community involvement in these services is critical there, because an awful lot of this is something that people see for themselves, it is commonsense, if you like. I do think that PCTs themselves are going to be under a lot of pressure to meet a wide range of targets and so on which will actually make it difficult to keep that focus.
  (Ms Herklots) I would agree with that. I think PCTs certainly offer an opportunity, and it is one we need to take hold of. At the moment they are very young organisations. It strikes me that they are quite head-down, trying to sort out their structure of what they are about, so I am not sure how quickly they will be in a position to pick up some of the things we have been talking about. I think it would be helpful if there were a clear steer from Government on these sorts of issues for PCTs. On the issue of incentives, I always get a bit worried about the penalty side of it and any perverse incentives it might create. We do need to bear in mind that one of the problems is around early discharge as well as delayed discharge. Certainly we would want to see a system that valued getting people out of hospital and put a value on actually doing that in the right way for the people concerned.

  281. Do you feel you have perverse incentives at the moment—that is, no incentive?
  (Ms Herklots) I think there is no incentive at the moment. I think there will be individual incentives for the NHS in terms of trying to discharge people, but there is not, it seems to me, a shared incentive, if you like, between all the parts of the system in terms of providing care.

  Andy Burnham: I think we have covered all the questions.

  Chairman: Do any of my colleagues have any other questions? If not, can I thank our witnesses for a very helpful session. We are most grateful to you. One or two of you have mentioned following up with additional information, and we would be very grateful if you could do that. Thank you for your co-operation.

previous page contents

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2002
Prepared 29 July 2002