green light for foundation trusts
WORKERS, OCTOBER 2003 ISSUE
Despite resistance, the green light has gone on to permit the implementation of foundation trusts in the NHS. Health care workers in those trusts and in the NHS in England (foundation trusts are not Scottish or Welsh policy) now have to decide what to do. In the trusts themselves the view is to see what benefit can be achieved for patients and to allow improved income generating opportunities to be translated into a healthy thriving organisation. Nowhere is there any suggestion that funds generated will escape from healthcare delivery.
Government intent is to move all trusts in England into this framework in due course. What does it mean and will it cause two-tier healthcare? The answers are probably not yet clear. Trusts may act with more freedom from central control or Strategic Health Authority approval, at least to some extent. All monitoring requirements to assure performance in relation to waiting lists etc remain unchanged.
The real changes will be in the ability to pursue projects costing over £1million without loads of hoops to navigate. Of course the worry of many is that foundation trusts borrow money, and then implement changes that are better arrangements/provision than in other hospitals. Much will depend on how workers in non foundation hospitals react. If it provokes demands for improvements then a divisive policy can become a progressive one.
The same response will be required if (and it is a big if) foundation trusts are so successful that they feel they can pay staff more money or fund more treatments than the 'poor' relation down the road. If foundation hospitals by paying staff more attract the best, and cause closures of beds elsewhere, then the public is not well served. All the health trade unions are currently beginning the implementation of a new national grading structure. In trade union terms attempts to introduce differential pay rates can be viewed negatively and passively or it can become an argument for negotiating better pay for all.