In Commissioning a Patient-led NHS, published in July, primary caretrusts were told they would have to abandon their role as a provider ofservices by 2008.
However, in a statement to Parliament last week, health secretaryPatricia Hewitt said health visitors, district nurses and othercommunity staff "will continue to be employed by their primary caretrust unless and until the trust decides otherwise, following full localpublic consultation". She added that the "terms and conditions of staffwill, of course, be protected".
A new deadline has yet to be set.
The move was welcomed by health professionals, who say the removal ofprimary care trusts' employer role has slowed down children's trusts'development.
Frank O'Friel, head of integrated children's commissioning at the Londonborough of Ealing Primary Care Trust, said the directive had caused"real anxiety" at all levels about where health visitors and schoolnurses would be employed.
"It's been hard trying to plan for children's trusts when that is goingon in the background - trying to plan how services develop together butwithout knowing who will be employing the staff," he said. "And staffworry about who will be employing them rather than being positivelyfocused on how to develop a children's trust model."
He added that though Ealing Primary Care Trust was consideringincorporating its community nursing team into the borough's children'strust, it was unhelpful to be "pushed" into doing this ahead ofschedule.
He questioned why the initial plan to divest primary care trusts oftheir employer role had not happened in tandem with the timescale forchildren's trusts, and why it had been rushed out ahead of the primarycare white paper, due out in December.
Dr Diane Gray, consultant in public health medicine at Milton KeynesPrimary Care Trust, said she anticipated that many primary care trustswould continue to contract out some or all of their staff under pressureto make savings and to focus on their commissioning role.
She also said there were fears that under private or non-NHS providers'service quality would suffer as they competed for the lowest costs byusing low-grade staff. Gray added there was concern that the use ofnationwide "provider chains" could result in the use of staff withlittle experience in an area's specific needs.
Parliament's Health Select Committee has announced it will investigatethe reforms and their impact and will begin taking evidence next week.
