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Tuesday, 15 January, 2002, 16:27 GMT
Anger at major NHS overhaul
How hospitals are managed is set to change
How hospitals are managed is set to change
Radical plans to allow managers from private industry to run failing hospitals in England have been criticised by MPs and unions.

Private management teams could be brought in to manage failing NHS trusts in an overhaul of the way England's hospitals are run.

Meanwhile, star performers are to be given a greater control over their affairs - including the right to set local pay rates with staff.

Health Secretary Alan Milburn announced the radical proposals to "redefine" the NHS in what he called his most important speech since taking office.

However, the Tories say the measures have not been thought through, and health service unions fear backdoor privatisation of the NHS.

Mr Milburn's immediate predecessor as health secretary, Labour's Frank Dobson has also expressed concerns.

We now have a clear set of frameworks and standards in place, it is time to let go

Alan Milburn
Addressing the New Health Network on Tuesday, Mr Milburn outlined how politicians and civil servants will relinquish overall control of the best-performing hospitals, which will not have to meet detailed targets.

External NHS managers and the private sector will be invited to take over the running of poor-performing units - probably those which received no stars in last autumn's performance tables.

Alan Milburn: set to spell out changes for the NHS
Alan Milburn will spell out changes for the NHS
The management of the new special health authorities - combinations of existing authorities that will start operating in April this year - could also be put out to franchise, but only within the public sector.

Time for change

Mr Milburn told the BBC that a national framework in standards was now in place for the whole NHS and backed up by a system of independent inspections.

He said: "With that framework in place it is time to let the best hospitals free.

"To put the doctors, nurses, the other staff and the managers in a position where they can improve services for patients, rather than trying to run the NHS like an old-fashioned, top down nationalised industry."

The last thing the public wants is to see the NHS turn into a new Railtrack

John Edmonds
Mr Milburn said the job of government should not be to run the system but to oversee it.

He wanted greater community ownership and less state ownership, leading to greater diversity in local services.

He added: "Where we have got a problem with the management of the poorest performing hospitals, we should not hesitate to change it."

However, union leaders have given the plans a frosty response.

John Edmonds, general secretary of the GMB union, said: "This shows that ministers are not prepared to listen to reason and are intent on forcing through backdoor privatisation of the NHS.

"It is staggering that at a time when the failure of rail privatisation is there for all to see the government is intent on making the same mistake with our hospitals.

"The last thing the public wants is to see the NHS turn into a new Railtrack."

Panic measures

This is actually a panic measure, designed to head-off further criticism of Alan Milburn's appalling mis-management of healthcare

Dr Liam Fox
Shadow Health Secretary Dr Liam Fox accused Mr Milburn of taking "panic measures".

He said: "The Health Secretary claims that this proposal holds the key to solving the crisis in the NHS.

"If it does, why isn't it in the Health Reform Bill?

"The answer is simple. This is actually a panic measure, designed to head-off further criticism of Alan Milburn's appalling mis-management of healthcare."

Frank Dobson
Frank Dobson expressed reservations
Mr Dobson told the House of Commons he was reluctant to criticise Mr Milburn's plans.

But he said the success of some NHS hospitals proved that they could do a first rate job without the need to franchise out control to the private sector.

"Would he give at least some thought to the fact that the public service ethic managed to maintain the NHS through all the Tory years of under-investment and malignant policies?

"Wouldn't it be right to give the public service ethic the opportunity to flourish with the extra resources that are now available?"

Local control

Under Mr Milburn's plans the 35 three-star trusts could become autonomous, self-governing "foundation hospitals" with the ability to spend their money as they see fit. They will have the option of establishing themselves as not-for-profit companies.

Currently if hospitals sell land, the money would have to go into a central pot.

Under the new scheme it is expected that three-star hospitals will be able to keep it for themselves.

They will also be able to appoint consultants as they see fit, without consulting a central body.

National pay levels will continue, but individual hospitals will be given the freedom to take account of local circumstances.

Performance will be checked via the new quality bodies, such as the Commission for Health Improvement.

The Department of Health is currently looking at whether the new plans need legislative changes.

The BBC's Karen Allen
"Ministers say it's now time to let go of the old NHS"
UK Health Secretary Alan Milburn
"This is not something that is going to be mandatory"
Conservative health spokesman Oliver Heald
"We are suspicious this is just tinkering at the margins"
Patient Association's Mike Stone
"We have to look at anything that benefits patients"
Will private help improve the NHS?



1162 Votes Cast

Results are indicative and may not reflect public opinion

See also:

15 Jan 02 | Health
NHS reform: Reaction
15 Jan 02 | Health
NHS reform: Hospital response
25 Sep 01 | NHS Performance 2001
Star ratings handed to hospitals
14 Jan 02 | Health
Code of conduct for NHS managers
26 Jul 01 | Health
Ministers blamed for NHS failings
01 Dec 01 | Health
NHS management review ordered
30 Nov 01 | Health
'Chaotic NHS cannot improve'
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