Rother fears over caring and sharing

Though local opposition means that a joint Hastings and Rother PCT will be retained, with a second PCT to serve the rest of the county, the proposal now is for "shared management teams."

The idea is being contested by Rother council.

As leader of Rother and chairman of the Rother Local Strategic Partnership, Cllr Gubby has written to Marianna Griffith, director of delivery and commissioning designate for the new South Coast Strategic Health Authority but currently chief executive of Kent and Medway Strategic Health Authority.

He says he is concerned to ensure that the appropriate management structures are in place.

"The needs of my residents, as far as health service is concerned, should be properly met in a cost-efficient way but equally an effective way reflecting local needs.

"In arguing strongly for two separate management teams I wish to refer specifically to the terms of reference that have been published by yourself and Candy Morris.

"The two specific conditions accompanying the decision of two PCTs for East Sussex include that 'the SHA should consider whether shared management teams would be benefit PCTs in meeting these criteria '¦'".

Referring to bullet points in the terms of reference, he says: "The first states that 'all PCTs must retain and build on the current partnership arrangements, including local area agreements already established in partnership with local authorities'.

"The East Sussex LAA was, at the insistence of all the boroughs and districts, only signed off by them because it specifically included and took account of the very local and discreet targets of the various local strategic partnerships,

"In other words, the whole LAA is locally focussed at district and borough level whilst at the same time covering the whole of East Sussex.

"The second bullet point specifically states that 'a strong locality focus should be retained and where necessary locality structures should be put in place '¦'. Yet again an emphasis on local focus and if necessary (which is not in our case) a local structure should be put in place.

"I argue that the existing structures for managing the PCTs, certainly as far as the Hastings and Rother PCT is concerned, are effective and very efficient.

"The third bullet point in the background paragraph states that 'all PCTs must also deliver their share of the 15% management cost savings '¦'. This authority, with other boroughs and districts and the county council, are already in detailed discussion to find efficiency savings through joint procurement and shared service provision, particularly back office functions.

"I am confident that, like Rother District Council, my colleagues will be keen to explore any opportunity with the two PCTs (and their respective management teams) for cost savings in support of your target.

"Elsewhere in the terms of reference one of the proposed outcomes is to 'maximise meaningful clinical leadership and engagement to ensure best health and health care for the residents of the two PCTs'.

"All layers of Government at present are signed up to the Communities and Neighbourhoods Agenda which gives local people a bigger say in services delivered to them and a greater say in the decision-making.

"This leads to a better choice and I believe a better level of service appropriate to their needs.

"I would argue the same for two management teams as we did for two PCTs.

"I hope that you will be guided by the terms of reference and the need to justify any decisions with clear evidence, not just to the eventual bodies managing the PCTs but also to the public to whom they deliver services."

In agreeing to two PCTs, the Minister required a review to be undertaken to assess the benefits or otherwise of a single management team.