There’s been a mixed welcome to the announcement of the next stage in
the plan for self-managed – or foundation – hospitals (See PublicNet
Briefing January 16, 2002). Some in the health service see them as a
vital first step in decentralising; while others worry they will create
division and demoralisation.
Alan Milburn has announced which hospitals will trial the scheme – which
involves more freedom on offering better pay, more freedom to sell land
and property to re-invest.
The doctors’ organisation, the BMA, sees it as an opportunity to ‘escape
from the heavy hand of Whitehall.’
The Royal College of Nursing is worried that to give some hospitals new
freedoms and not others is to create a two-tier system which will work
against the partnership working increasingly looked for to deliver a
successful healthcare system.
The RCN is also concerned that the special treatment for some hospitals
might work against another Government priority – equality of access to
treatment – with the free hospitals able to perform much better than
The biggest concerns are raised by the NHS Confederation, the voice of
the trusts and health authorities which make up the service.
During their annual conference this week, chief executive Gill Morgan
said that if freedoms were thought to improve performance then they are
needed by all.
She said, “It is often those hospitals that are failing that most need
the freedoms to improve. There is also a major risk that relationships
between all the parts of the system will suffer – we need to be focused
on systems of care for patients and the relationships between the parts
of the NHS and within organisations not on organisational changes.”