09 May 2003
The Audit Commission has hit out at government plans to allow its controversial foundation trusts to appoint their own external auditors.
As the Commons debated the Bill that would establish the new trusts, commission chair James Strachan said trust-appointed auditors would not employ the same level of probity as those appointed by his organisation.
'It seems very strange that foundation hospitals are said to be in the NHS family but that their audit regime will not be accountable in the same way,'
he said.
A private sector audit of the hospitals' books would, he said, not be the same as a 'public sector audit of performance, of value for money, and of governance'.
The Health and Social Care (Community Health and Standards) Bill contains provision for an independent regulator, but the terms of the job are not spelled out. Strachan's attack was another setback for the government in its attempts to reform the NHS.
In the Commons, opponents of foundation trusts vowed to attempt to alter the Bill in its committee stage after it survived an initial revolt by a substantial minority of Labour MPs on May 7. The Commons voted by 304 to 230 to give it a second reading, having turned down an amendment to stop the Bill by a majority of 180.
Earlier, Health Secretary Alan Milburn said the reform would increase co-operation and raise standards across the NHS. He added that he had no objection to primary care trusts gaining foundation status but this could not happen until they had matured as organisations.
Milburn did drop a hint about the scale and identities of the first wave of trusts to receive foundation status, which is due to be announced later this year.
He said many would be in deprived areas, naming Liverpool, Bradford, Sunderland and Doncaster. 'Thirty-two trusts have applied and I hope to be able to approve the vast majority of them,' he added.
The emergence of foundation trusts has, apparently, dealt a blow to the NHS shared services initiative, though sources close to the initiative said it was very much alive.
Shared services centres were due to be introduced compulsorily across the English health service over the next few years, saving up to £500m. Savings on this scale will not now be realised, though the shared services agency may become an arm's-length body of the Department of Health that would bid to win contracts from NHS organisations.
The centres were due to reduce overheads by centralising financial and human resources transactions. Common finance and e-purchasing systems would not now be introduced.
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