Examination of Witnesses (Questions 280
WEDNESDAY 13 MARCH 2002
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 momentthat 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
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.