The best is yet to come

BMJ 2008; 337 doi: (Published 14 November 2008) Cite this as: BMJ 2008;337:a2484
  1. Adrian O’Dowd
  1. 1Margate

    Breaking strings from government has put foundation trusts at the top of NHS performance tables. Adrian O’Dowd talks to the head of their regulatory body

    With England’s 109 foundation trusts sitting comfortably in the top half of NHS performance tables some might consider the work of William Moyes, executive chairman of Monitor, the regulatory body for the trusts, done. But the man who has been described as a “breath of fresh air” for the health service since his appointment in 2004 thinks that more people could benefit from trusts that put clinicians in charge and loosen government control.

    “I think foundation trusts’ performance has been very impressive, but I still think the best is yet to come. You are dealing with a hospital system that for the best part of 60 years has been, in effect, run from the centre, with ministers issuing guidance that was, to all intents and purposes, instruction,” says Moyes.

    About half of all acute (46%) and mental health (54%) NHS trusts in England have gained foundation status since the idea of more independent NHS organisations started to become a reality in April 2004.

    Although progress has been steady it has not been speedy enough, according to Moyes, who is a plain speaking and demanding leader.

    “I am disappointed that we have not managed to have all hospital care delivered by foundation trusts,” he says. “The progress with the programme of referring applicants to us …

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