Policy Exchange: Future Foundations

Last Wednesday saw the publication of the inquiry into the failures at Mid Staffordshire hospital where over 400 patients needlessly died.   The inquiry was ordered by the Secretary of State in response to the public outcry.  The recommendations are, of course, worthy and have been well received by both patient and professional groups alike.  But as there is still appetite for a further inquiry – relatives, families and the Conservatives are calling for a full public inquiry – what was the legal basis for the first?

Mid Staffordshire is a Foundation Trust Hospital.  Foundation Trust Hospitals were created specifically to be independent of the NHS, and of the Secretary of State. The creation of Foundation Trusts was one of the most bitterly contested NHS reforms introduced by Tony Blair. At the time they were opposed by Conservatives and many within the Labour party, now both political parties want to make every hospital a Foundation Trust.  But Foundation Trusts are different; they are accountable to their local communities, not to the Secretary of State.  So while the urge for politicians to interfere in these matters is intense, their powers are necessarily limited.

The policy of creating Foundation Trusts was designed to create a new set of structural relationships within the NHS.  The development of the new structure was, amongst other things, an attempt to create a new culture.  But the old culture of tight central control – the one that NHS managers and civil servants feel safest in – still remains dominant within the Department of Health,and within the minds of Government Ministers as well.

As we pointed out last week, the fundamental failings at Mid Staffordshire were those of the system of hospital oversight and scrutiny, not the policy of Foundation Trusts.  On the whole, Foundation Trust hospitals are much more highly performing than those remaining under tight central control.  So how do we create a culture where the NHS can adopt more of the changes that allowed Foundation Trusts to flourish?   Well, what if the architects of Foundation Trusts were to reveal all in a new Policy Exchange pamphlet later this week…

Henry Featherstone is Head of the Health Unit at Policy Exchange. “Future of Foundations: Towards a new culture in the NHS” will be out this week.

Related posts:

1. Policy Exchange: Safety in Numbers
2. Policy Exchange Is Wrong – Northern Cities Do Have A Bright Future
3. Policy Exchange: A State of Disorder
4. Policy Exchange: More fees please?
5. Policy Exchange: Surface vs depth