Foundation hospitals: freeing the best or dividing the NHS?

BMJ 2002; 324 doi: (Published 01 June 2002) Cite this as: BMJ 2002;324:1298

Last week Health Secretary Alan Milburn announced plans to set the best NHS hospitals free from Whitehall control. Ann McGauran looks at the pros and cons

The government wants the hospitals and primary care trusts that perform the best to gain foundation status and thereby win greater freedom from Whitehall. Will this development liberate a new generation of public sector entrepreneurs, or is the concept poorly thought through and a sure route to “sink” hospitals?

The hunt for ideas for how they could work is an international one. Last week executives from Spain, Sweden, and Denmark shared their experiences of running non-profit independent hospitals with a select group that included NHS chief executives from three star trusts and large teaching hospitals.

Health secretary Alan Milburn told the London seminar that new legislation would be needed to set up foundation trusts as “free-standing legal entities.” He pointed to growing interest in the idea of a public interest company (PIC) - a non-profit body with a clear public service ethos and protected against private sector takeovers.

The first wave of foundations will be chosen from those achieving three star ratings this July, he added, with “firm expressions of interest” already received from four NHS trusts: Northumbria Healthcare, Peterborough Hospitals, Norfolk and Norwich University Hospital, and Addenbrooke's. Those meeting the criteria would start operating in shadow form by next April.

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