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Health secretary Patricia Hewitt has performed a U-turn on plans to stop PCTs providing services directly.

She will tell MPs this week that reforms set out in Commissioning a Patient-Led NHS will be made 'less prescriptive', allowing PCTs to continue direct service provision.

GPs and PCTs had raised concerns about the future of services such as district nursing if trusts had to contract them out.

Dr David Jenner, NHS Alliance commissioning lead, said: 'The problem with going so fast is that you can throw out what works along with what doesn't.'

Dr George Ewbank, PEC chair of Ashfield PCT and a GP in Sutton-in-Ashfield, Nottinghamshire, said the retreat would allow 'local determination' to overcome 'central dogma'.

He added: 'It also takes the pressure off the immediate vast changes in services so we are better able to plan to provide them.'

Dr Chaand Nagpaul, chair of the GPC commissioning and service development subcommittee, said the retreat was a consequence of 'developing sudden policy without thought'.

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