09 May 2003
Foundation trusts will increase inequity and lead to wage inflation and aggressive staff poaching, the Commons health select committee said this week.
The committee's report, which was published to coincide with the Commons debate, concluded that the initiative could have a destabilising effect on the NHS.
The MPs said the government was 'too ambitious' in its belief that all trusts would reach foundation status within five years, despite this week's announcement of a £200m fund to help every trust gain the necessary three stars.
'As trusts will have to achieve three stars in order to qualify for foundation status, how can we be confident that non-foundation trusts will improve their performance that dramatically and quickly when the performance of approximately 70% of trusts in the star ratings system either remained the same or fell between 2001/02?' asked committee chair David Hinchcliffe.
With their greater financial muscle, foundation trusts could attract non-foundation trusts' patients by shortening their waiting times or improving quality.
'As money follows patients, poorer-performing hospitals will see their revenue streams dry up and will have even less to invest in improving services, locking them into a downward spiral of poor performance,' he added.
The report also said that wage inflation and staff poaching could happen in areas where relations between NHS organisations were poor and where health care staff shortages were greatest, such as London.
The MPs recommended the reforms should be piloted in all trusts in a geographical area and incentives should be introduced to ensure foundation trusts maintain and improve their standards.
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