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Parliamentary showdown for foundation trust plans

Published on 03/11/03 at 03:15pm

Health Secretary Alan Milburn has published the final plans for the controversial foundation trusts with the promise that all NHS hospitals could become self-governing within four or five years.

Enshrined in a new bill, the plans have had their first reading in the Commons and look certain to be Mr Milburn's greatest challenge since becoming Health Secretary three and half years ago.

One hundred and sixteen Labour MPs have already signed a motion voicing opposition to the policy; their leading concern of a two-tier health service being created echoed by many NHS professional bodies and patient groups.

But the plans have gone down well with the three star-rated trusts invited to be in the first wave, with 32 acute trusts already in the process of applying for foundation status.

Mr Milburn's plans have altered significantly since they were first proposed a year ago, with Chancellor Gordon Brown demanding safeguards to guarantee their accountability to the Treasury and local people.

Announcing the bill, Mr Milburn said foundation trusts would help decentralise the NHS, create a new form of public ownership, democratise the service and ensure better value and greater transparency for spending on health and social care.

"This bill is about strengthening the link between local communities and the local health services," he said.

"This bill takes forward the NHS Plan commitment for an NHS where standards are national but control is local. Every NHS hospital will have the opportunity of becoming a Foundation Trust over a four to five year period. It will help to construct the modern, democratic 21st century NHS our nation needs."

The hospital governors will include members of the local community and be elected by local people.

The trusts, to be known as 'Public Benefit Corporations', will be monitored by the two new independent inspectorates - one for health services and one for social services - to ensure the trusts represent good value for money.

The Commission for Healthcare Audit and Inspection will report to the public on the extra services, improved quality and better care they can expect from the increased Government spending on the NHS. The Commission for Social Care Inspection will perform parallel duties for the social care element of acute trust work.

The first foundation trusts are due to come into being in 2004, but the bill's operating conditions could be significantly amended by concerned MPs and the House of Lords.

Former Health Secretary Frank Dobson and Health Select Committee Chairman David Hinchcliffe are leading the opposition to the bill, claiming the plans are elitist and a Tory consensus.

The Conservatives published their own plans to de-centralise the NHS and cut out bureaucracy just two days ago, with Shadow Health Secretary Dr Liam Fox pledging foundation status for all hospitals and the scrapping of all centrally administered NHS targets.

The 32 trusts applying for foundation status are:

  • Royal National Hospital for Rheumatic Diseases (specialist)
  • Basildon and Thurrock General University Hospitals
  • Kings College Hospital
  • Sheffield Teaching Hospitals
  • Papworth Hospital (specialist)
  • Calderdale and Huddersfield
  • Newcastle Upon Tyne Hospital
  • Addenbrookes
  • 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
  • Guys and St Thomass
  • Moorfields Eye Hospital (specialist)
  • City Hospitals Sunderland
  • Frimley Park Hospital
  • Southern Derbyshire Acute Hospitals
  • East Cheshire
  • Rotherham General Hospitals

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