Socialist Resistance

An archive of socialistresistance.org, 2002–2022

Campaigning for the NHS

Socialist Resistance no11  |  page 8

This is scanned newsprint, not web text. The original PDFs carried no text layer at all, so every word here was read off the page by OCR. Expect dropped opening letters, run-together words and wrong characters. There was no contents page to cut the paper up by, so the articles were found from the size of their headlines: a headline may carry its kicker, and where an article ran beside a boxed panel a few lines of the neighbour can appear. The scanned issue is the authority; this text is here so the words can be found at all.

On November 6 the House of Lords effectively threw out key sections of New Labour's controversial Health & Social Bill establishing Foundation Hospitals, setting the scene for a fortnight of lobbying and arm-twisting before it goes back to the Commons on November 19. If Labour backbenchers hold firm, and a few who voted for the policy last time join the opponents, it could be defeated. But what is all the fuss about? JOHN LISTER replies to some frequently unanswered questions. How are Foundations different from existing Trusts? While only the top-performing 3-star Trusts can become Foundations, any other organisation may apply to become a Foundation Trust (eg BUPA, PPP, or American private medical providers such as Kaiser Permanente).

NHS Trusts that become Foundations will no longer be property of the Crown: they will also have additional freedoms to sell "unprotected" assets and to borrow money within "prudential" limits (yet to be defined).

Each Foundation will be a 'Public benefit corporation' = not-for-profit company: a copy of the authorisation will be held at Companies House. While their non-profit status means they cannot share surpluses with shareholders, they are expected to run as a company and to generate surpluses. In a cash-limited NHS, this can only come at the expense of reduced revenue for non-Foundation Trusts.

These new companies will be governed by an "independent regulator", who will be appointed by the Secretary of State, and theoretically answerable to Parliament. The Regulator will have extensive powers to shape the license for each Foundation Trust - but also to approve subsequent changes.

While their principal purpose has to be the provision of "goods and services" for the NHS, Foundations are also free, provided the regulator agrees, to carry on other activities on their own behalf or jointly with private sector organisations.

Foundations will be outside the NHS planning process: they are not directly accountable to ministers or to local Strategic Health Authorities - and will have purely a contractual accountability to the Primary Care Trusts, which will commission services from them.

Foundations are also free to ignore existing NHS systems of consultation and complaints: they are not obliged to operate Patients' Forums. Austra