ANNEX A: Outline of the existing law relating to the NHS(12) PCTs
242.In England, PCTs are a new tier of administrative body below HAs, and have primarily been concerned with the Part 1 system, although they may exercise certain HA functions relating to GMS.  PCTs are established by the Secretary of State by orders under section 16A of the 1977 Act (as inserted by section 2(1) of the Health Act), with a view to their carrying out the activities listed in paragraphs (a) to (c) of that section.  Their functions are conferred, in the main, by directions given by HAs under section 17A of the 1977 Act, as inserted by section 12 of the Health Act.  There is currently no power for Secretary of State to delegate his functions direct to PCTs although he can under s17A(4) direct HAs to so delegate their ‘delegable’ functions.    Under section 18(3) the Secretary of State can make regulations precluding the ‘delegator’ exercising delegated functions.  It is expected that all PCTs (i.e. covering all of England) will be established and operating by April 2002.
243.Most HA functions are delegable to PCTs (s17A).  S17A(3) sets out those ‘excepted functions’ which may not be delegated.
244.In the exercise of the functions under Part 1 of the 1977 Act delegated to them by their HAs, PCTs have taken on the “commissioning” activities of the HAs.  Unlike HAs, however, they also provide certain services (usually community health services rather than hospital services) in the exercise of those functions.  A PCT is something of a “hybrid” between a HA and an NHS trust.  The other significant feature of PCTs is that the regulations for the membership of PCTs made under paragraph 5 of Schedule 5A to the 1977 Act, as inserted by Schedule 1 to the Health Act, provide that a substantial number of PCT members and PCT committee members must be GPs, local nurses and other health care professionals providing or assisting the provision of services under the 1977 Act.