02 May 2003
Foundation trusts will not be able to opt out of the NHS's Agenda for Change pay deal, Health Secretary Alan Milburn confirmed this week as he launched a concerted campaign to quash opposition to the scheme.
Speaking at a joint King's Fund and Social Market Foundation seminar, Milburn said that all foundation trusts would have to work 'within the flexibility of Agenda for Change'.
'The beauty of it is that it gives national guarantees of equality but provides some local flexibility to recognise that there are different market-led areas. If we don't have flexibility then we will have difficulty recruiting,' he said on April 30.
This confirmation may dispel some union opposition to the policy, with several, including Amicus and the Royal College of Nursing, still to vote on it.
But his main opposition is still within his own party, with up to 100 Labour MPs expected to rebel when the foundation trusts Bill gets its second reading in the Commons next week.
Milburn's speech was carefully crafted to quell some of this disquiet; reiterating that it was not 'privatisation through the back door' and claiming that the policy was built on Labour principles.
'NHS foundation trusts will remain part of the NHS, providing services to the patients according to NHS principles,' he said.
Echoing Prime Minister Tony Blair's pledge to push forward with public services reform, he said: 'The government's foot needs to be firmly on the accelerator, not on the brake.
'If we fail to match high and sustained investment with real and radical reform it will be the centre-Left's argument that will face extinction.'
He also moved to crush arguments that foundation trusts will create two-tier health services. 'All hospitals will be paid a nationally set price for the same procedure. There will be payment by results, but NHS foundation trusts cannot make a profit.'
As a sop to rebellious Labour MPs, he outlined applications from seven trusts for foundation status in either deprived or Labour heartland areas including Hackney in east London, Doncaster in Yorkshire and Sunderland in the Northeast. If successful, he said, these trusts would improve services.
The King's Fund, which broadly supports the policy, warned that the government would have to reassess the levels of freedoms granted to trusts if they were to have more than a 'marginal impact'.
PFmay2003
