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EDITIONS
 Tuesday, 21 January, 2003, 01:03 GMT
Doctors criticise NHS reforms
Addenbrookes NHS Trust
Trusts like Addenbrookes could gain freedom
Government plans to give top NHS trusts more freedom will create a two-tiered health service, the British Medical Association has warned.

Senior doctors say foundation trusts will only serve to widen the gap between the best and worst hospitals.

They also warn ministers against allowing trusts to set their own terms and conditions for staff, saying it will exacerbate recruitment problems.

I see the potential both for a real conflict between primary care trusts and foundation hospitals and for unhelpful and divisive competition between neighbouring hospitals

Dr Ian Bogle, BMA
The Department of Health has dismissed the BMA's claims saying they will improve NHS care.

The BMA sets out its case against the policy in evidence submitted to the influential Commons Health Committee.

In its report, the trade union calls on the government to concentrate on helping under-performing hospitals instead.

It suggests that these hospitals could benefit most from extra freedom and that the current focus on top-rated trusts is misguided.

Three-stars

Ministers are planning to announce the first wave of NHS foundation trusts this summer.

Only trusts which receive the top rating of three stars in Department of Health league tables will be eligible for foundation status.

Under the plans, they will be able to set their own clinical and financial priorities for the first time without interference from Whitehall.

They will be modelled on similar hospitals in Denmark, Spain and Sweden and will be run on a not-for-profit basis.

The BMA said it is particularly concerned about reports that foundation trusts will be allowed to set their own rates of pay for staff.

In its report it states: "The flexibilities offered to foundation hospitals are likely to leave other trusts with worsening recruitment difficulties, especially in recruiting the most experienced and most sought-after staff, an effect which will be particularly marked on neighbouring trusts.

"The department has recently announced that measures will be introduced to stop foundation hospitals from poaching staff, but is silent on how this immensely difficult objective will be achieved."

Concerns

BMA chairman Dr Ian Bogle urged Health Secretary Alan Milburn to take the association's concerns on board.

He said: "We know that foundation hospitals are a project close to the health secretary's heart and we share his desire to encourage innovation and improved care for patients.

"I hope, however, that he will give due heed to the very real concerns expressed by doctors in both primary and secondary care.

"The health service has too many policy initiatives pulling in different directions. I see the potential both for a real conflict between primary care trusts and foundation hospitals and for unhelpful and divisive competition between neighbouring hospitals."

Dr Bogle also warned that foundation trusts must not be allowed to cut costs in the areas of medical research or training.

"I am also concerned about the future of medical training and research in foundation hospitals which might well try to opt out of their responsibilities in this area in order to cut costs and increase patient throughput."

A Department of Health spokesman denied claims foundation trusts would create a two-tiered NHS.

He said all trusts would continue to provide free treatment to NHS patients and would be inspected to the same national standards.

The spokesman said foundation trusts would remain part of the health service and would be required to work in partnership with the local NHS.

"They will be required to use their freedoms in a way that does not undermine other trusts' ability to meet their obligations, for example by poaching staff," he said.

The Commons Health Committee is expected to publish its report into foundation trusts in the spring.

See also:

09 Jan 03 | Health
11 Dec 02 | Health
14 Nov 02 | Health
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