Plan to set free top hospitals

by BEEZY MARSH, Daily Mail

The best NHS hospitals are to be freed from Government control, it was revealed yesterday.

Foundation Hospitals, as they will be known, will manage their own budgets and can ignore targets set by Whitehall.

They will be liberated from monitoring by the Department of Health and held to account through cash-for-performance contracts.

The Foundation NHS Trusts will be 'public interest companies' - not-for-profit organisations which combine a public service ethos with private sector entrepreneurial skill.

The hospitals, which must meet the highest standards under the NHS star ratings system, will be able to plough funds raised from sales of NHS land back into their own services.

Hospitals will be paid by results so that those which perform more operations will get the most cash.

A new commission will monitor standards of care.

The creation of Foundation Hospitals was outlined by Health Secretary Alan Milburn yesterday.

He said: 'The expectation must be that the greater freedoms that these trusts will enjoy will help them exceed national performance targets.'

He added: 'NHS Foundation Trusts will operate in quite a different way from existing NHS Trusts. NHS Trusts were supposed to guarantee self-governing status. In fact they were at best a half-way house, and at worst a sham.

'The challenge now must be to genuinely free the very best NHS hospitals from direct Whitehall control.'

Under his plans, which will require fresh legislation, the first hospitals will be announced in the autumn.

They will be set up as shadow Foundation NHS Trusts next April, with full status being granted later in the year.

Those hoping to join the first wave include Northumbria Healthcare NHS Trust, Peterborough Hospitals NHS Trust, Norfolk and Norwich University Hospital NHS Trust and Addenbroke's NHS Trust in Cambridge.

But unions and NHS managers fear other hospitals could become 'poor relations' where patients will not want to be treated and staff will be reluctant to work.

Doctors' leader Dr Ian Bogle, chairman of the British Medication Association Council, said: 'We will want to work with the Government to ensure that we don't create a two-tier system of Foundation Hospitals and second division hospitals, some of which are locked into a downward spiral, and where patients are left without the quality of care they deserve.'

Nigel Edwards of the NHS Confederation, which represents health service managers, said: 'They have got the diagnosis right - there is too much control from Whitehall - but the treatment wrong.

'Why should it be that innovation is only possible in the bestperforming hospitals? It is often those doing less well which need the most radical approach to turn them around.

'It doesn't go to the heart of the problem which is top-down control from Whitehall which is affecting all trusts.'

Karen Jennings, of health union Unison, said: 'At the same time as creating Foundation Hospitals, you run the risk of creating a poor relation in the surrounding trusts.

'The morale of hard-working staff in hospitals that don't achieve foundation status will be badly undermined.

'And many nurses will be tempted to move to Foundation Hospitals and exacerbate recruitment and retention problems in the surrounding areas.'

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