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PCT claims bullying over private contract

Published on 03/06/04 at 03:07pm

An NHS trust chairman has accused the government of bullying it into awarding a contract to a private firm, resulting in him losing his job.

The government signed a nationwide deal with South African firm Netcare to carry out 41,600 cataract operations from mobile theatres in areas of England with long waiting lists over the next five years.

The board of South West Oxfordshire Primary Care Trust voted against proposals to sign up to the scheme last November only to change its mind a month later.

The dispute arose because the trust's non-executive directors said the trust could do the work just as quickly and cheaper than Netcare.

Former chairman Professor Martin Avis says the Trust came under pressure from the government to accept the contract, with a DH spokesman telling the BBC that it "made no apologies" for encouraging the NHS to sign up to the scheme.

This is despite the fact that NHS chief executive Sir Nigel Crisp had indicated in December that PCTs would be allowed to veto treatment centre contracts, a reflection of its pledge to devolve power away from Whitehall.

Professor Avis alleges health secretary John Reid ordered the board to change its mind and send a progress report to him.

"My chief executive was told that the minister [John Reid] required a reversal of the decision on his desk early the following week," he told the BBC.

Professor Avis was asked in January to reapply for his job as PCT chairman but decided against doing so, while non-executive director Jane Hanna also resigned recently, backing up her chairman's claims of government interference and coercion. "There is no room for local autonomy," she said.  "I am not willing to be a 'rubber stamp' for government. The public is sold the message that they [PCTs] are the key to decision making in the NHS today and that is simply not the case."

Confronted about the allegations of government coercion on BBC Radio 4's File on 4 programme, Sir Nigel said: "That was not a message that came from us. There are 300 PCTs in this country and they are increasingly making decisions on behalf of their populations with support from health authorities and others," at which point Sir Nigel abruptly ended the interview and left the studio.

The NHS Alliance is also concerned about whether government insistence that the grip from the centre is loosening is reality or just rhetoric, saying: "Some PCTs are talking privately about coercion and outright bullying by their SHAs. We are aware of resignations by clinicians and non-executive directors because they feel unable to carry out their roles effectively."

NHS Alliance chairman Dr Michael Dixon said: "SHAs - and even the top table [SHA chief executives and the eight NHS Tsars] appear to misunderstand the difference between performance management, which is the proper role of SHAs, and instructing how services should be commissioned, which is not."

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