GP consortia could be forced into commissioning health care for children and young people in secure children's homes and training centres, lawyers have warned.
Care Services Minister Paul Burstow announced earlier this month that the NHS would take over commissioning for these groups - who often have complex health needs. Currently, the institutions themselves commission the care with funding from the Ministry of Justice.
PCTs took over commissioning care for prisons and young offender institutions in 2006 when they were handed to the NHS, but with PCTs being abolished under the NHS reforms, there is uncertainty about whose responsibility the secure centres will be.
Chris Webb-Jenkins, a partner at solicitors Browne Jacobson - which acts for over 50 unitary or top-tier local authorities and over 20 NHS trusts - warned that GP commissioners could end up shouldering the responsibility. "At first glance this makes practical sense. Claims that this will help ensure consistency between each establishment and continuity of care once the individual leaves the secure establishment, seem plausible. "But where precisely within the NHS will this responsibility sit, and for how long? Will it rest with soon-to-be-abolished PCTs or SHAs? Will it then pass to soon-to-be-established GP consortia, or the National Commissioning Board? "There is great uncertainty about the future of health commissioning generally due to the lack of detail in the Health and Social Care Bill, and exacerbated by recent political friction which casts doubt of how much of the bill will survive into law. The practical implementation of today's announcement will be watched closely for clues as to the future," he added.
Secure training centres are purpose-built centres for young offenders up to the age of 17. They are run by private operators under contracts which set out detailed operational requirements. There are four in England - Oakhill in Milton Keynes, Bedfordshire, Hassockfield in Consett, County Durham, Rainsbrook in Rugby, Northamptonshire and Medway in Rochester, Kent.
Secure children's homes are generally used to accommodate young offenders aged 12 to 14, girls up to the age of 16, and 15 to 16-year-old boys who are assessed as vulnerable. They can accommodate young people involved who are involved in the Criminal Justice System or who need to be detained for welfare reasons.
A Department of Health spokeswoman said she was unable to confirm whether health services for young offenders will be dealt with by the National Commissioning Board or GP consortia because of the current ‘pause' in the Health and Social Care Bill.