Reconfiguration of primary care trusts and Strategic Health Authorities

On 12 April 2006, the Secretary of State for Health, Patricia Hewitt, announced structural reform of Strategic Health Authorities (SHAs).

Reduction in SHAs

The 28 existing SHAs were to be reduced to cover 10 areas. The 10 areas were designed to be co-terminous with government regional offices.

The restructure was designed to deliver stronger commissioning functions, provide better value for money and reduce bureaucracy by bringing together administration functions.

Reduction in primary care trusts (PCTs)

On 16 May, the proposed restructuring of SHAs was confirmed in the House of Lords and it was announced that primary care trusts (PCTs) would also be reconfigured from 303 organisations down to 152.

The population covered by each PCT was to rise from an average of around 165,000, to an average of approximately 330,000. 70% would be co-terminous with local authority boundaries (compared to 44% pre-reform).

Criticism

This restructuring was criticised at the time by Earl Howe, who stated in a House of Lords debate that:
'In 2001, in the document called Shifting the balance of power, the government announced that 302 PCTs would replace the existing health authorities and that the nine regional offices of the NHS executive would be abolished in favour of 28 strategic health authorities. The announcement today effectively returns the NHS to a very similar organisational configuration to the one which the government abolished only three years ago. That fact alone is enough to call the judgment of ministers and officials into question.'

Implementation

Despite the criticism received, the 28 SHAs were reduced to 10 on 1 July 2006, and the 303 primary care trusts were reduced to 152 on 1 October 2006.