Health service "modernisation" Milburn's non-stop "modernisation" plans are simply compounding the anger of NHS staff
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WHI TON would again rule the roost, and that the usual suspects - ex-councillors, former MPs and "safe" bigwigs from local quangos and businesses - will find themselves included, with the usual absentees- working people, and those with disabilities and particular health needs - once again to be left on the outside.
Some of Milburn's colleagues, such further, and argued that Foundation Trusts - supported as they are by the Tory Party, and Thatcherite organisations such as the Institute of Directors and the Adam Smith Institute - represent "popular • • • socialism" and hark back to the 'old Labour', 'socialist' values of "mutualism" and the cooperative movement
But the Foundations will be run as busi nesses, and encouraged to show entrepre neurial spirit: they will have to pay commercial interest on any loans they take out with the private sector.
They may not be for-profit bodies, but they will have to break even, and will seek to retain a growing surplus year on year. We should expect that, like City businesses, they will set up a generous scheme of bonuses and salaries for their top directors
And they will inevitably seek to strengthen their market share by competing against other Trusts for contracts to treat more NHS patients as another aspect of Milburn's reforms - a re-establishment of the internal market system through a new system of payment by results - takes effect.
They may even pick and choose which specialies and serices they
see it as economic to offer to local Primary Care Trusts - and which they see as less attractive, and therefore leave to non-Foundation Trusts.
With so many unanswered questions, it is perhaps surprising that a mere two dozen Labour MPs out of the 109 who had signed a motion opposing it abstained on the sec. ond reading of the legislation for Foundation Trusts.
The level of debate will have to be raised before this latest half-baked plan is railroaded through with few if any health workers in support.