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Health Insight May 2002: Hospitals:  the good, the best and the bad

  At a conference of top NHS managers from the UK and other European countries, Health Secretary Alan Milburn outlined plans for thirty-five best-performing hospitals in the country to be freed from strict Whitehall management and financial control. He said they would become independent, not-for-profit enterprises with an ‘annual cash-for-performance contract’ and power to spend NHS funds as they see fit. The hospitals would be neither conventional public-sector nor private-sector bodies, but a type of hybrid organisation for which there is no UK model. Mr Milburn is expected to cite hospitals in Spain, Sweden and Denmark as enterprises from which the UK could learn.

The ‘foundation’ hospitals need to have received three-star ratings in the Department of Health’s annual performance tables. At least four top-performing NHS trusts already look set to be given complete freedom to decide how they work. Hospitals in Cambridge, Northumbria, Peterborough and Norfolk are to apply to join the first wave. If successful, the hospitals will start operating as shadow NHS foundation trusts next April and, subject to legislation, will become fully operational before the end of 2003.

A single hospital trust wrecked targets on cutting NHS waiting lists. The monthly figures of the Royal United Hospitals in Bath showed that up to 280 patients had been made to wait for more than fifteen months for an operation. In the whole of the rest of England, however, just one patient was in a similar queue. Health minister John Hutton said that firm action was being taken and several senior management figures had already resigned or been suspended. Mr Hutton said, ‘The isolated problem of one hospital must not cloud what is a considerable achievement for NHS hospitals and staff throughout England. There is a long way to go, but the facts speak for themselves.’

Source: The Times 11th May, Independent 22nd May, BBC Online, Press releases (DoH)

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