Should trusts be allowed to fail?BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7094.1566 (Published 31 May 1997) Cite this as: BMJ 1997;314:1566
If failure is inevitable, the process should be planned and managed
- C Chantler, Children Nationwide professor of paediatric nephrologya,
- A Maynard, Professor of economicsb
- a United Medical and Dental School, Guy's Hospital, London SE1 9RT
- b Department of Economic and Related Studies, University of York, York YO1 5DD
The logic of competition and the inevitable product of collaboration in healthcare markets is that there will be winners and losers. At present, Britain's self governing NHS trust hospitals compete to provide services for patients, and the loss of contracts, for whatever reason, makes their viability uncertain. This was recognised in the government's original white paper on the internal NHS market,1 which stated that the assets would revert to the ownership of the secretary of state if a trust was wound up. It has now been reported that Anglian Harbour NHS Trust will be dissolved on 31 August after losing contracts to neighbouring trusts.2 The viability of many other trusts in other places is in doubt, and they await the decisions of the new government to determine their fate.
The contraction of the hospital sector is not new. A recent report from the University of London notes that the number of acute beds in …