01 August 2003
The prime minister's invitation to a further 38 NHS trusts to apply for foundation status is premature, the King's Fund said this week.
During his monthly press conference on July 30, Tony Blair announced that the 38 three-star trusts not included in the first wave of foundation trust applicants had been asked to apply in the autumn of 2004 or the spring of 2005.
He extended the controversial scheme, which will give the trusts greater freedom from Whitehall control, despite last month's Commons revolt that almost threw out legislation to establish the trusts. Further opposition is expected when the Bill passes to the Lords in the autumn.
Critics believe the foundation initiative will create a multi-tiered NHS, with resources and highly-skilled staff concentrated in the best hospitals.
The King's Fund said the scheme could deliver improvements but insisted that no one could be sure of its impact. 'The prime minister's decision is premature as it will not allow time for the careful piloting and independent evaluation of the scheme that is crucially needed,' said Jennifer Dixon, the think-tank's health policy director.
The prime minister also sparked controversy by almost doubling the number of operations that will be performed in fast-track surgery and diagnosis units run by the independent sector.
Fifteen NHS Diagnosis and Treatment Centres are already open, with a further 31 in development. An independent sector DTC is being piloted and the Department of Health is expected to announce soon the preferred bidders for 18 of them. The first is due to open by January 2004 and they are expected to provide 136,000 operations. Blair said this week they would also perform 125,000 more orthopaedic procedures within five years.
British Medical Association chair James Johnson said the DTCs would help meet waiting list targets. But he added: 'The BMA wants to know where the money will come from to fund the extra work to be carried out by DTCs. Primary care trusts have to fund local hospitals that are offering a 24-hour service to patients and it is essential that resources are not redirected to DTCs.'
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