Dr Beverly Malone, General Secretary of the Royal College of Nursing said:

"The RCN welcomes the publication of this important report. We entirely endorse the Committee's recommendation that the government must more carefully consider the impact of its proposals on NHS staff. RCN evidence also shows constant change is destabilising, affects morale, and the ability of the NHS to recruit and retain staff. There remains a problem with nurse shortages and the Government's proposals risk making the difficulties worse, potentiallyaffectingpatient care.

"We agree with the committee's view that the consultation process on PCT reform should be full, fair and inclusive; and we share its concern about the potentially negative impact on healthcareof contracting out PCT provider services to the private and voluntary sectors.

"We therefore recommend this report to ministers and urge them to carefully consider its conclusions and recommendations."

ROYAL COLLEGE OF NURSING (UK)