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NHS Financial Management

The Secretary of State for Health (Ms Patricia Hewitt): I am today announcing that we will be rolling out across the national health service a new programme of financial diagnostic checks and providing the opportunity for two-star acute specialist and mental health trusts to apply for NHS foundation trust status. The concerns about financial management in some parts of the NHS have encouraged us to work with Monitor (the statutory name of which is the independent regulator of NHS foundation trusts) to develop these new financial diagnostic tools and pilot them in two strategic health authority areas. These new financial tools will help trusts prepare for foundation trust status. Bringing two-star rated organisations into the applications process for foundation status will give a greater number of trusts the opportunity to put forward their proposals for foundation status.

The Whole Health Community Diagnostic Project will drive a culture of improved financial management across the NHS and give acute trusts a clear indication of any areas for improvement before they embark upon the NHS foundation trust application process. It will assess the financial robustness and viability of all trusts that have not yet applied to become NHS foundation trusts, in the context of their wider health economies, as well as looking at other authorisation requirements such as management and governance arrangements. The project will provide an assessment of what needs to be done to get NHS acute trusts in England ready to apply for NHS foundation trust status.

To be authorised as an NHS foundation trust by Monitor, applicants have to be able to demonstrate their clinical and financial viability and sustainability as well as their overall capacity and capability to take on the additional freedoms and flexibilities. Monitor's authorisation process is a disciplined and very challenging process. It ensures that NHS foundation trusts are clinically and financially sustainable, effectively governed, locally representative, legally constituted and well managed. This is important if they are to operate with sufficient autonomy, achieve and exceed national healthcare standards and become increasingly responsive to their communities. In allowing two-star acute, specialised and mental health trusts to apply to Monitor in addition to three-star organisations, there is no question of lowering standards for authorisation as an NHS foundation trust. Monitor will continue to be a rigorous as before in determining whether applicants can be authorised for foundation trust status.

NHS performance ratings have so far only been used as a way of identifying which trusts could be invited to apply for foundation status, but they are not part of the formal authorisation criteria. In 2006, the Healthcare Commission (the statutory name of which is the Commission for Healthcare Audit and Inspection) will replace the NHS performance ratings with an annual healthcheck performance rating system. It is therefore an appropriate time for the Government to revisit the entry requirements for foundation status and to broaden the base for applicants because the three-star requirement is too restrictive.
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There are currently 32 NHS foundation trusts in operation. They are sustaining the core NHS principles of universality and equity, and collectively serving more than a quarter of the population in England. The continued rollout of NHS foundation trusts across the NHS is giving the public, patients and staff a louder voice in how their local healthcare services are designed and run. The Healthcare Commission's independent review of NHS foundation trusts and other reports have highlighted the significant benefits and opportunities presented by foundation status. We know that independence from central Government control and greater freedoms are giving NHS foundation trusts the opportunity to innovate new approaches to healthcare and healthcare services, for the benefit of NHS patients.

The Government remain committed to providing all NHS trusts with the opportunity to apply for NHS foundation trust status within the next three years. The decision on when to apply remains one to be taken locally.

National Creutzfeldt-Jakob Disease Surveillance Unit

The Parliamentary Under-Secretary of State for Health (Caroline Flint): The National Creutzfeldt-Jakob disease Surveillance Unit's (NCJDSU) 13th annual report has been published today. The report documents the unit's findings in relation to sporadic, familial and iatrogenic Creutzfeldt-Jakob disease, and also variant Creutzfeldt-Jakob disease up to 31 December 2004. Copies have been placed in the House Library, and the report is also available on the NCJDSU's website at


Bichard Inquiry

The Secretary of State for the Home Department (Mr. Charles Clarke): Hon. Members will recall I made a statement to the House on 11 January 2005 updating them on progress in implementing Sir Michael Richard's recommendations arising from his inquiry into issues surrounding the Soham murders. I have today placed in the Libraries of both Houses copies of the Government's second progress report on the on-going work. Although Sir Michael has now taken a step back from this work, it is in response to his suggestion that the six-monthly cycle of reporting be sustained that I have chosen to report now and I will offer a further update to the House in March 2006.

It is now clear that the inquiry has been a catalyst which has concentrated both the Government and the public services on improving the safeguarding of children and vulnerable adults. We are making good progress across the 31 recommendations, with a number already achieved and others nearing completion. We remain fully committed to implementation of the whole programme and to ensuring all the necessary resources are available. Beyond that, we will ensure that safeguarding remains a key priority as our broader work to improve delivery continues. For example, within the "Every Child Matters" initiative and as part of the development of the new National Policing Improvement Agency.
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Sir Michael's recommendations have forced us to take a long hard look at the ways in which the police manage and share information. As a result, the IMPACT programme (Information Management, Prioritisation, Analysis, Co-ordination and Tasking) which is now in place will deliver huge changes to working practices and technology. These will greatly reduce the risk of the kind of failings in information sharing which formed part of the background to the Soham murders. A comprehensive code of practice on police information management will come into force on 14 November and will be backed up by extensive training and operational guidance. New technology to enable information sharing between forces will begin rolling out to their Child Abuse Investigation Units by the end of this year. This new capacity for sharing will be progressively extended as systems develop through to 2009 and beyond.

Equally crucial are arrangements for sharing information between the police and other agencies such as social services. Key improvements are being developed as part of the current work to revise the Working Together framework which will be completed by the end of this year.

The development of a central vetting and barring scheme covering all those wishing to work with children or vulnerable adults is well underway. It will provide a comprehensive, centralised and integrated system to prevent unsuitable people from gaining access to vulnerable groups through paid or voluntary work. It will be implemented via the Safeguarding Vulnerable Groups Bill which will be introduced during this session.

New on-line training for head teachers and school governors covering the need to emphasise safeguarding as part of staff recruitment procedures has been developed. It was successfully launched in July and the scope to extend this training beyond the education sector is being considered.

Existing vetting procedures are also being strengthened. A Quality Assurance Framework to assist police forces in carrying out their roles in the vetting process has been finalised and is being rolled out.

Sir Michael was very supportive of the governance and co-ordination arrangement put in place and we have maintained the programme structure based on effective joined-up working across the Government Departments and delivery agencies involved. We are working closely with all stakeholders and agencies to ensure the interdependencies are properly managed and the projected benefits realised. At the point of delivery, training arrangements are being put in place to support implementation, together with targeted inspection and performance measurement regimes to ensure compliance with new and improved systems.

It is vital to ensure the same level of protection for all children and other vulnerable people, wherever they are in the United Kingdom. The Scottish Executive, the National Assembly for Wales and the Northern Ireland Office have therefore been closely involved in this programme of work. For some of the recommendations, the route to implementation will differ between jurisdictions, but the objective of effective, integrated systems is the same. The arrangements in different jurisdictions are set out in more detail in the report.
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There are no shortcuts to delivering on the letter and the spirit of the Bichard inquiry, but the achievements and plans set out in the latest progress report are evidence of our commitment. The momentum must be maintained and I will provide a further update to this House in March 2006.

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