FOUNDATION hospital chiefs are worried that the Government’s flagship NHS reform programme is being strangled by bureaucrats and unexpected changes to the original vision.
The new-style hospitals, which Tony Blair hopes will save the NHS, say that they are being smothered in red tape and are in danger of losing the powers that they were promised to help patients.
The decision by chief executives in the vanguard of the scheme to speak out will come as a blow to the Prime Minister, who fought off critics in his own party to give the best NHS hospitals new freedoms in the boldest of his public-sector reforms.
It comes after the Government snatched back £1 million bonuses from foundation hospitals earning three stars and set their borrowing powers much lower than expected.
Foundation hospital chiefs are also unhappy with plans drawn up for the Department of Health to cap their profits and force them to hand them over to other NHS bodies.
Advertisement
One chief executive told The Times: “If, in a year or two years’ time, we end up with all these reforms watered down to the extent there are no advantages to being a found-ation trust, then what was the point of the whole programme?” Some of the hospitals give warning that the whole programme could fail, just as the Conservative hospital reforms did in the early 1990s — suffocated by red tape.
Robert Naylor, chief executive of University College London Hospitals NHS Foundation Trust, said: “You cannot give freedoms to a foundation trust and a matter of 17 weeks later come along and start changing those freedoms.”
Mark Britnell, chief executive of University Hospital Birmingham NHS Foundation Trust, said that new NHS bodies, including strategic health authorities, were stifling the hospitals.
“I have noticed an increasing lack of coherence between national inspection and regulation bodies and, more alarmingly, a desire to control,” he said. “It would appear that some new players and old characters are quietly at work to keep control of power and, perhaps inadvertently, maintain the status quo.”
The independent foundation trust regulator admitted yesterday that things seem to be “getting worse rather than better”. William Moyes told The Times: “If you took a snapshot in isolation, it does look as though there are more controls and more burdens and it does look as if the old system of command and control is reasserting itself.
Advertisement
“But I feel quite strongly that this is just a timing issue and I think, in the next few weeks, the trusts will see proposals from the department to reduce information burdens quite significantly.”
But his optimism was not shared by chief executives contacted by The Times who include some of the strongest advocates for the policy.
Peter Herring, chief executive of the Countess of Chester Hospital NHS Foundation Trust, said: “I am totally supportive of the concept and the spirit in which foundation trusts were set up. This was a movement to create a more businesslike and commercial environment.
“What we fear is that, because we have to operate with the rest of the system . . . (it) has to adopt the same sort of principles. Our fear is that the rest of the bureaucracy are swarming around us like antibodies around an infection, trying to kill us off.”
Paul Lilley, chief executive of Gloucestershire Hospitals NHS Foundation Trust, said he feared being held back by bureaucracy. “If we fudge issues for fear of failure, we are setting our sights much lower than we could,” he said.
Advertisement
“The more that foundation trusts are allowed to run with their new freedoms and the system reforms without being unnecessarily constrained by bureaucracy, the better we are likely to do for patients.”
Andrew Cash, chief executive at Sheffield Teaching Hospitals NHS Foundation Trust, called on ministers to hold their nerve. “We are presently running a couple of systems, the old system and the emerging new one,” he said.
“Inevitably there is an anxiety at the moment. It is an important period and, given the strong political will we have got on this, I think the right system will win out. Otherwise nothing will change.”
The Department of Health said that decisions on the review of hospital profits had not been made. A spokesman added: “Policy on foundation trusts was developed following extensive consultation with staff, patients, the public and chief executives of three-star trusts about what extra freedoms they would need in order to be able to go further and faster to improve services for NHS patients.”