A PUBLIC consultation was launched by West Hertfordshire Health Authority last week on proposed changes to the health service structure in the county.

These proposals comprise of the creation of seven Primary Care Trusts, the merger of West Hertfordshire Health Authority and North and East Hertfordshire Health Authority and the formation of a county-wide trust for mental health, learning disability services and some community services in west Hertfordshire, including child health.

Primary Care Groups came into effect last April, as part of the Government's national commitment to modernise the NHS, which act as sub-committees of health authorities.

Now, like others in the country, Watford and Three Rivers and Dacorum PCGs want to become PCTs.

Hertsmere PCG, which consulted the public last year, is due to become a PCT this October.

If Watford and Three Rivers' and Dacorum's proposals are approved by Health Secretary Alan Milburn, they will take over many of the responsibilities of West Hertfordshire Health Authority, and actually plan and have budgets to provide services they feel the community they serve needs, from April next year.

Reporter CAROLINE COOLEY asked Dr Peter Reader, chairman of Watford and Three Rivers PCG and a Watford GP, how the changes would affect patients.

What is a PCG?

'They are locally based NHS organisations that bring together GPs, district nurses and other community staff - known collectively as primary care - to help them deliver the right care for their patients.

'They work in partnership with other organisations that can influence health, such as social services, voluntary groups and local councils, to improve health of people generally.

'There are five PCGs in west Hertfordshire, and ours cares for 170,000 patients which live within the two council boundaries.

'PCGs are run by a board of local GPs, nurses, social services representatives and a lay member, which enables what a PCG does to be significantly influenced by local professionals who work day-to-day looking after patients.

'This is one of the benefits its fundholding predecessor was able to deliver by giving GPs direct control over some NHS budgets but, in PCGs, this has been enhanced by the inclusion of the other professional groups and the greater coordination and partnership of care.

'We believe the PCG has made a good start this year. We have been able to put money directly into GPs practices to buy more nurse time and develop other services, often only previously available in hospital.'

Why does Watford and Three Rivers PCG want to become a PCT?

'Becoming a PCT will allow us to build on this.

'We have increasingly strong links with all our professional partners and have developed with them and the public a local plan for health, called the Health Improvement Plan (HimP), which will help focus everyone's efforts on a few priorities.

'We also want to develop support services for patients in the community in areas such as rehabilitation, for example, by supporting people immediately after discharge from hospital, which is a very difficult time for many.'

What can a PCT do that a PCG cannot?

'While the PCG has offered many opportunities, the PCG board believes even more could be achieved as a PCT.

'A PCT can employ community professionals and own premises itself, whereas a PCG cannot.

'This would give us far greater control and flexibility over developing the rehabilitation services just mentioned.

'Basically, we believe it would enhance our ability to have a local focus to deliver the best care to our patients.'

Are there any disadvantages?

'It is fair to say, while there are professionals who are enthusiastic about this opportunity, there are those who remain sceptical, because they don't like change.

'This underlines the need for everybody, including the public, to become involved in the process and the future development of health services within the PCG. They are, after all, your health services and we need your help to support and improve them.'

The consultation on all three proposals ends on October 16. To order a copy of any of the consultation documents, write to Ms Jo Walter, Charter House, FREEPOST 145, Parkway, Welwyn Garden City, Hertfordshire, AL8 6BR.

Dates and venues for the public meetings are being finalised.

ccooley@london.newsquest.co.uk

Picture T271685A: PETE STEVENS

A PUBLIC consultation was launched by West Hertfordshire Health Authority last week on proposed changes to the health service structure in the county.

These proposlas comprise the creation of seven Primary Care Trusts, the merger of West Hertfordshire Health Authority and North and East Hertfordshire Health Authority and the formation of a county-wide trust for mental health, learning disability services and some community services in west Hertfordshire, including child health.

Primary Care Groups came into effect last April, as part of the Government's national commitment to modernise the NHS, which act as sub-committees of health authorities.

Now, like others in the country, Watford and Three Rivers and Dacorum PCGs want to become PCTs.

Hertsmere PCG, which consulted the public last year, is due to become a PCT this October.

If Watford and Three Rivers' and Dacorum's proposals are approved by Health Secretary Alan Milburn, they will take over many of the responsibilities of West Hertfordshire Health Authority, and actually plan and have budgets to provide services they feel the community they serve needs, from April next year.

Reporter CAROLINE COOLEY asked Dr Peter Reader, chairman of Watford and Three Rivers PCG and a Watford GP, how the changes would affect patients.