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No-star PCTs facing private takeovers

Managers of zero-starred PCTs could be kicked out. The Department of Health says private companies will be asked to bid to take over if the PCTs fail to improve.

In a threat aimed at motivating poorly-managed trusts Giles Wilmore, head of NHS performance, said that in extreme cases troubleshooters would be parachuted in.

The department has yet to finalise the role of strategic health authorities in assessing the improvement plans that all zero-starred trusts must draw up by October. But a spokes- man said if support from the NHS Modernisation Agency failed to remedy problems, powers were in place for the Secretary of State 'to require individual NHS organisations to change their senior management'.

He added: 'Such changes would be brought about through the franchising pro-cess. The SHA may invite bids from the private and voluntary sectors as well as the NHS.'

Dr Mike Dixon, NHS

Alliance chair, said it was unfair to threaten zero-star trusts when the Commission for Health Improvement based ratings on anachronistic quality indicators. Ousting senior managers would demoralise GPs, other clinicians and patients, he added.

'The whole thing is worrying. The principle is that local professionals should decide what happens in a PCT. I can't see a commercial or private operator [working], as PCTs are run by personal relationships.'

Dr David Mendel, professional executive committee chair of zero-starred Hounslow PCT, said he had no objection in principle with replacing managers of trusts that failed to improve performance.

But he added: 'If you are going to franchise you need to do it globally.'

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