As far as inherited debt is concerned, the cost of PCT lay offs can be written off provided they take place before April 2011 because consortia will only inherit debts accrued after that date. Later redundancies are quite different: new consortia could have their finances devastated by a large, last-minute round of PCT lay-offs.
Some PCTs are trying to palm staff off to consortia under the Transfer of Undertakings (Protection of Employment) regulations (TUPE). If PCTs can TUPE staff across they don't have to pay redundancy: the downside is that any consortium which takes on these staff now inherits their accrued redundancy entitlement, which may stretch back for 20 years. If the consortium then finds they are superfluous to requirements, or not up to scratch, the financial consequences could be enormous.
A more sinister version of this ploy concerns PCT staff already vired to practice-based commissioning (PBC) groups. Although the PBCs aren't directly responsible for their salaries, these staff can insidiously acquire employment rights: not only will consortia find them harder to remove, but the PCT will have reduced its redundancy responsibilities yet again.
Then there is voluntary redundancy. This means an existing PCT employee could get a sizeable severance package, only to walk into a similar NHS job with a consortium.
In these days of NHS budget stringencies we need legislation to control the more questionable of these financial practices. Consortia should be free to acquire the people they want, without PCT or PBC managers being foisted on them under TUPE. In particular, all redundancy payments should be excluded from inherited PCT debt. This would stop any PCT delaying laying off staff so as to pressurise consortia to TUPE staff across at the last minute to avoid increasing consortium debts.
Finally, any NHS employees taking voluntary redundancy should be required to return their severance pay if they take, or arrange to take, a similar job in the NHS within three months.