Stronger safeguards are needed to protect partnership working
between the NHS, primary care trusts and councils to prevent
foundation hospitals failing groups such as those with mental
health problems, a parliamentary committee has warned.
In its report on foundation hospitals, the first of which will
begin operating next April, the health select committee says it is
“strongly supportive” of the development of community-based
But it adds that it is “imperative” the trusts do not lead to a
shift back in favour of acute services and that people with chronic
illnesses, such as those with mental health problems who are often
treated in community-based care settings, are not
The introduction of foundation hospitals has divided Labour MPs and
many critics believe it will lead to a two-tier health
They argue that, while three-star hospitals will be the first to
gain foundation status, winning greater financial freedoms and less
control from the Department of Health, poorer performing hospitals
may be starved of cash and become worse.
Committee chairperson David Hinchliffe said he had heard no
evidence to reassure him that foundation trusts would not “entrench
inequalities still further”, adding that the worst hospitals would
become “locked into a spiral of decline”.
Liberal Democrat shadow health secretary Evan Harris said the
£200m announced this week to help poorly performing hospitals
to gain foundation status was no more than a “gimmick”.
There are also concerns that those hospitals that win foundation
status might not have increased power to develop locally driven
targets, which could mean they are unable to direct greater
resources towards, for example, children’s health improvement
through the Sure Start initiative.
Mental health trusts are prevented from bidding for foundation
status because their ratings system is not considered
well-developed, but the report urges the government to extend the
status to mental health trusts as a “matter of priority”.
Primary care trusts are also excluded from applying because they
are too new and, according to Milburn, need to “develop their
ability to commission”.