Rebels fail to halt foundation trust plans
pharmafile | October 28, 2003 | News story | |
The Government has won a crucial House of Commons vote in favour of its plans to allow top-performing hospitals to become foundation trusts.
Over 130 Labour MPs had signed a Commons motion opposing the reforms but persuasion from Prime Minister Tony Blair, Health Secretary Alan Milburn and pressure from party whips meant that no more than 63 Labour MPs voted against the plans.
The rebels fear that the more autonomous trusts would create a two-tier NHS and further burden the system with unnecessary reform.
The Conservatives also voted against the bill, but claimed that it did not go far enough, with Shadow Health Secretary Dr Liam Fox accusing Chancellor Gordon Brown of "emasculating" with too many checks and balances.
"They will still be subject to suffocating government targets through the star rating system, the emasculating of borrowing powers will create a dog-eat-dog culture within the system", he said.
David Hinchcliffe, Labour MP and Chairman of the Commons Health Select Committee, tabled an amendment to de-rail the bill, but this was also easily defeated by 299 votes to 117.
Rebels have, however, vowed to fight on, and say they can wreck the bill in its later stages.
Labour MP Glenda Jackson told BBC Radio 4's Today programme: "I have little doubt that over the following weeks, when the bill is in committee, there will still be a continuing effort on the part of those who don't wish to see the basic principles of the NHS destroyed [making] these arguments".
Many of the concerns raised by Labour rebels and other political opponents also emerged in the report by the Select Committee.
A number of NHS trust executives were invited to give evidence, but the Committee reported that many were reluctant to discuss the plans at this early stage.
David Jackson, Chief Executive of one hospital applying for foundation status, Bradford Hospital NHS Trust, told the Committee he understood that foundation status would offer less Government icro-management', citing new DoH plans to introduce 'modern matrons' as an example of a current centrally-imposed target that he considered burdensome.
He concluded that if greater freedom did not materialise "many of us will say it is perhaps not an idea with is worth pursuing".
Malcolm Stamp, Chief Executive of another foundation trust applicant, Addenbrooke's Hospitals NHS Trust, told the Committee that freedom to set more locally driven targets would make the new status attractive.
"If we are going to get buy-in at a board of governors level it would be good to have relevant targets emanating from that engagement, rather than just follow the national targets", he said.
The Committee also noted that uncertainty remained over how the performance of foundation trusts would be monitored, with NHS watchdog CHAI unable to provide information on the subject, despite Alan Milburn recently indicating that foundation trusts would stay in the star rating system.
Independent health analysts the King's Fund also warned that the plans could see current 'top down' control replaced by 'horizontal' control by PCTs or regulatory bodies, potentially leaving little room for autonomy.
A number of health economists pointed out that the creation of NHS trusts in the 1990s produced fewer freedoms than originally promised.
The 32 trusts applying for foundation status are:
Royal National Hospital for Rheumatic Diseases (specialist)
Basildon and Thurrock General University Hospitals
King College Hospital
Sheffield Teaching Hospitals
Papworth Hospital (specialist)
Calderdale and Huddersfield
Newcastle Upon Tyne Hospital
Addenbrooke
University Hospital Birmingham
Nuffield Orthopaedic
Walsall
Aintree Hospitals
Bradford Hospitals
University College London Hospitals
Essex Rivers Healthcare
Doncaster and Bassetlaw Hospitals
Countess of Chester Hospital
Stockport
Homerton University Hospital
Queen Victoria Hospital (specialist)
North Tees and Hartlepool
Royal Devon and Exeter Healthcare
Gloucestershire Hospitals
Peterborough Hospitals
Royal Marsden Hospital
Guy and St Thomas
Moorfields Eye Hospital (specialist)
City Hospitals Sunderland
Frimley Park Hospital
Southern Derbyshire Acute Hospitals
East Cheshire
Rotherham General Hospitals
