The coalition government's white paper Equity and Excellence: Liberating the NHS represents one of the biggest shake-ups of the NHS in decades.
It outlines plans to axe a whole tier of management. In place of primary care trusts (PCTs) and strategic health authorities, GPs would be given greater powers to commission health services locally.
But chief executive of the National Children's Bureau Sir Paul Ennals is among those concerned about the possible impact of the proposals on partnerships between health and children's services.
For the past two years, local authorities have been required by law to create children's trusts that bring together all children's services. In many areas, says Ennals, this has successfully brought together PCTs, councils and local voluntary sector providers. He fears the new proposals could set joint working practices back.
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