Shake-up a threat to care, says thinktank

Abolishing primary care trusts (PCTs) could delay treatment and undermine efforts to save 20bn, according to the thinktank Civitas.

It follows claims that PCTs are in "meltdown" over plans which will see GPs take over responsibility for buying NHS services.

Concerns over the reforms are believed to be shared even at the Treasury and in Downing Street and Cabinet Office Minister Oliver Letwin has been called in to examine them.

Ministers are now due to unveil key details of how the plans will be implemented.

Civitas says it is "very uncertain" that abolishing PCTs will lead to significantly improved commissioning in the short, medium or long-term, damaging patient care.

James Gubb, of the Civitas health unit, said: "The Coalition Government needs to stop repeating the mistakes of the past by mandating wholesale structural change.

"Instead, it should seek to build on the best of what currently exists in NHS commissioning while permitting entrepreneurial GPs to take over in areas where the desire is there or PCT commissioning is failing.

"The risks of ripping up the current commissioning structure in its entirety in favour of new, inexperienced, organisations at a time when the NHS must focus squarely on driving productivity like never before are unquantified and in all likelihood unacceptably high."

A Department of Health spokeswoman said GPs were already coming forward to "shape the future of the NHS" and meet productivity challenges.

"Reform is a necessity in order to deliver continuous improvements in the NHS and achieve health outcomes that are amongst the best in the world," she added.