The unions have given the Government a bloody nose over the issue of
foundation hospitals with a resounding vote of no confidence in the scheme. So where
does that leave the HR profession, which has supported the plans all along?
The future of foundation hospitals, acclaimed by HR professionals as the way
forward, is starting to look rocky.
Originally, the Government only faced union opposition, but last week the
party faithful at the Labour Party conference rejected its plans. And now, many
are predicting that its likely that Tony Blair faces a possible House of
Commons defeat as well.
David Hinchliffe, Labour chairman of the Commons health select committee,
claims the proposal could be cut from the Health and Social Care Bill when it
returns to the commons at the end of the month.
"I think we can defeat it now," he said. "And, if I was a
betting man, I would say we will."
The policy to build foundation hospitals, which aims to give top-performing
hospitals the financial freedom to spend as they see fit, has been criticised
since the day it was mooted.
Opponents fear a two-tier system will develop, with staff being poached from
non-foundation hospitals, leading to a decline in their quality of service.
But HR professionals disagree, saying achieving foundation status will give
them the ability to respond to local needs, and will ultimately improve the
standard of patient care.
Mike Griffin, HR director at Kings College Hospital NHS Trust, said he hopes
that foundation hospitals get the go-ahead.
"If [the plans for] foundation hospitals fell at this late stage we
would be very disappointed, and would see it as an opportunity lost," he
The trust has applied for foundation status, and Griffin believes this is
the way forward.
"Being a foundation hospital is of considerable advantage to patients
and users," he said. "It would strengthen and enhance the quality of
Griffin said he does not believe trusts with foundation status would poach
NHS HR director Andrew Foster echoes Griffin’s view. In June, Foster told
Personnel Today that while he could understand concerns that the creation of foundation
hospitals might lead to a two-tier health service, the fears were unfounded as
every hospital would eventually be granted foundation status.
"This approach is a process intended to raise everybody’s
standards," he said. "Eventually, foundation trusts will be the
Foster said that while the NHS waited for all trusts to achieve foundation
status, local employers may be required to co-operate with each other and
ensure that trusts did not enter into price wars.
The Association of Healthcare Human Resource Management (AHHRM) also backs
the scheme, claiming it will provide greater opportunities for HR.
Peter King, executive officer at AHHRM, said the organisation is watching
the situation. "But," he said, "at the end of the day we are
public servants, and will do what the Government wants."
He said foundation status offers many advantages, but trusts need to be sure
that they have the HR capacity to cope with the changes.
However, despite reassurances from health secretary John Reid that the plan
was "the greatest peacetime programme of improving the NHS", unions
are still unhappy about the proposal.
In his final conference speech before retiring as general secretary of the
Transport and General Workers Union Sir Bill Morris said the plans for
foundation hospitals had been "worked out on the back of an
envelope", and would lead to "excellence of the few and misery for
He said successive Tory governments had tried to dismantle the NHS, and the
development of foundation hospitals "would be a self-inflicted wound – a
gift to a future Tory government to destroy the NHS".
Dave Prentis, general secretary of Unison, the biggest health workers’
union, proposed at the Labour Party conference the motion that the plans should
be shelved. He said the reforms were "ill-conceived", and would
divide "the best from the rest".
Prentis said he was very pleased with the vote and the fact that so many
constituencies had supported the union.
"All we want to do now is say to the Government that this is your
chance to listen," he said. "We want to sit down and talk about how
to deliver the best possible healthcare for all our people."
The British Medical Association also wants ministers to drop the policy. It
fears that if just a few trusts are given foundation status in the first wave
of implementation, they will receive preferential treatment, and inequalities
in the health service will increase.
By Quentin Reade
Under the foundation scheme hospitals plan:
– The hospitals will remain NHS hospitals
– Health secretary Alan Milburn claims patients will get better
care as the freedom from day-to-day Whitehall control will encourage more
innovation in service delivery
– Local people and staff will, for the first time, be able to
elect hospital governors
– Making foundation trusts more locally accountable will
particularly help to improve services in poorer areas
The 29 NHS trusts which have
applied for foundation trust status are:
Basildon and Thurrock General Hospitals
Calderdale & Huddersfield
City Hospital Sunderland
Countess of Chester
Doncaster and Bassetlaw Hospitals
Essex Rivers Healthcare
Guy’s and St Thomas’ Hospital Homerton University Hospital
King’s College Hospital
Moorfields Eye Hospital
North Tees and Hartlepool
Nuffield Orthopaedic Centre
Rotherham General Hospital Royal Devon and Exeter Healthcare
Sheffield Teaching Hospitals
Southern Derbyshire Acute Hospital
Newcastle upon Tyne Hospitals
The Royal Marsden
The Queen Victoria Hospital University Hospital Birmingham
University College London Hospitals