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Community care 'going to NHS' trusts'

Health authorities appear to be favouring NHS trusts as providers of community care in residential homes for the mentally ill and handicapped, major charities alleged yesterday in the wake of the row over the dismissal of Mencap as the manager of three residential homes in Birmingham.

James Churchill, chief executive of the Association for Residential Care, an umbrella organisation for 150 charity, independent and private home providers, including Mencap, said: "There is growing concern about the relationship between NHS trusts and their former parents, the health authorities."

In theory there is a clear split with the authorities buying services from whom ever can best provide them. "But there are concerns that health authorities are favouring trusts to the exclusion of other providers."

Mr Churchill was unable to name any other direct examples, and the North Birmingham health authority is adamant that the advice it sought from staff of the local community NHS trust, which is to take over the Mencap contract, was purely professional, not commercial.

But Mr Churchill said that, in the North-west, contracts for services had been advertised purely in NHS journals, not the social care ones that independent providers were more likely to read. And, in the South-west, a community trust had approached local providers suggesting they sell up to the trust "because you aren't going to win any more contracts. It is not clear how they could say that, when it is the health authority that does the purchasing," he said.

The concerns were at the level of anecdote, he said, and Fred Heddell, chief executive of Mencap, said: "The evidence that this is happening is not great, but there is an underlying fear and concern about it."

David McCabe, Mencap's local manager, said the charity intended to fight North Birmingham's decision and continue providing the care.