A health select committee report published on Tuesday said PCT commissioners were ‘too passive' and lack the skills to challenge hospitals, despite reports that up to 14% of NHS funding went on admin and management costs.
The report concludes: ‘If reliable figures for the costs of commissioning prove that it is uneconomic and if it does not begin to improve soon, after 20 years of costly failure, the purchaser/provider split may need to be abolished.'
The committee report suggests that strategic health authorities should bear the brunt of any cuts that need to be made.
It adds: ‘If we are to keep PCTs they need to strengthened. In particular, they require a more capable workforce, with people able to analyse and use data better to commission services. They also need to improve the quality of management, attracting and developing talent.'
The report is scathing of the DoH's ability to prove the value of commissioning.
It says: ‘We were appalled that four of the most senior civil servants in the DoH were unable to give us accurate figures for staffing levels and costs dedicated to commissioning and billing in PCTs and provider NHS trusts. We recommend that this deficiency be addressed immediately.'