Poor managers 'put NHS at risk'

By Nick Triggle
Health reporter, BBC News

Lord Darzi's review set out a vision to improve the quality of care

"Striking and depressing" local management is putting future improvements in the NHS at risk, a report by MPs has said.

The House of Commons' health committee said poor analytical and planning skills meant the aims set out in last summer's review risked being missed.

But the MPs also criticised key parts of Lord Darzi's plans for England, including the creation of polyclinics.

NHS managers said the MPs had been unfair and progress was being made.

The Darzi review was published to coincide with the 60th anniversary of the NHS.

Ministers hailed it as a fitting vision for a modern health service.

We remain very concerned that PCTs are not yet up to the task of putting these reforms into practice Kevin Barron, health committee chairman

At its heart was a demand to improve the quality of care by giving patients more choice and greater power in exercising their rights.

This included creating personal budgets for those with long-term conditions so they could decide how NHS money was spent on them.

Doubts cast

It also called for the opening of polyclinics - super health centres housing a range of services including GP surgeries - across the country.

And the review paved the way for the first-ever NHS constitution setting out what patients could expect from the service.

Regional bosses also came up with their own priorities which ranged from tackling rising alcohol consumption to widening access to care.

But the cross-party group of MPs cast doubt on the ability of local health managers working for what are called primary care trusts (PCTs) to see through the vision.

They went as far as to describe the quality of management as "striking and depressing", adding more emphasis needed to be placed on recruiting and developing better managers.

Meanwhile, the report said the creation of polyclinics should have been piloted first with the final decision over whether they were needed left to local areas.

'Real change'

Health committee chairman Kevin Barron said the emphasis on quality and leadership in the Darzi review was welcome.

But he added: "We remain very concerned that PCTs are not yet up to the task of putting these reforms into practice.

"Lord Darzi's reforms must not just be the latest in a series of failures to make real change."

Both the British Medical Association and the Conservatives agreed with the criticisms of the polyclinics initiative.

Shadow health secretary Andrew Lansley said: "It's worrying that such an expensive and lengthy review of the NHS has come up with virtually no new ideas and is more spin than substance."

But David Stout, of the NHS Confederation, which represents managers, said: "I think it is a narrow and unfair view of management in the NHS.

"There has been a lot of progress in recent years and we are aspiring to fulfil the vision."

Health minister Lord Darzi said PCT skills are being rigorously assessed.

"I accept that there is more work to be done to strengthen PCT commissioning."

But on the issue of polyclinics he added "every single part of the country" will benefit from them.