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Health and Education

It is entirely a problem. The moment a keen, go-ahead GP consortium—I have one in my constituency, although it is not the one that has complained to me particularly—wishes to make changes in its budget and use any savings to develop the service, it first needs the consent of the PCT. It is extremely difficult to secure the consent of the PCT. Most are not geared up to agree and many do not have the necessary skills. The result, as surveys in the Health Service Journal and so on show, is a high level of frustration, with GPs having signed up to the new approach but large numbers thinking that it has so far not made a significant difference to the standard of service in their areas. I should therefore like to ask whether the bland reference in the Queen's Speech to a patient-led service will lead to more progress in that area. At one time it was thought that the private sector would bring in expertise. The Secretary of State played that down in a speech that he made in February. He has now announced that there are private sector providers that will be able to give advice to PCTs, but only a small number of PCTs seem prepared to take that advice. I wait to see whether the Secretary of State will be any clearer about the way out of the present confusion, because he has to make the system work if he is not to find himself presiding over a service that is in an even worse crisis than on the day he took over.