An inquiry by the Health Select Committee has raised serious questions about the commissioning capability of PCTs.
The same report, summing up its recent inquiry into commissioning also warns the Government's world class commissioning drive is in danger of becoming a ‘tick-box exercise'.
The Health Committee accused PCTs of having ‘misplaced confidence' in their own ability and said trusts' perceptions of how they were performing were often removed from reality and spoke of ‘complacency' among NHS managers.
The report also cast doubt on whether the world class commissioning scheme could address ‘the lack of capacity and skills at PCT-level and weak clinical knowledge'.
‘There are concerns that WCC will be no more than a "box ticking" exercise whereby people expend a lot of energy merely demonstrating they have the right policies in place, rather than actually transforming patient outcomes and cost effectiveness.'
The detailed inquiry, which has heard evidence from the BMA, RCGP, and the King's Fund, plus senior civil servants and ministers, said the purchaser/provider split and the Government's commissioning policies 'may need to be abolished' if research proves they are 'uneconomic'.
Responding to the committee's verdict, Dr Judith Smith, head of policy at the Nuffield Trust questioned whether PCTs had been given a ‘fighting chance' of making strong commissioning work.
She said: ‘Hospitals and other providers of NHS care remain too powerful – they are often adversarial and are not pulling in the same direction as commissioners. This must be acknowledged and tackled. But to do so and develop ‘strong' commissioning as the Health Select Committee report suggests, would make life very uncomfortable for politicians and policy-makers as hospitals would downsize and some services would be curtailed to make way for new ones.'