Select Committee on Health Sixth Report

1  Introduction

1.  On 3rd July 2008 the Health Committee held a single evidence session on foundation trusts (FTs). Witnesses included Monitor, the regulator of FTs, a selection of representatives from FTs and NHS organisations that work with them, and academic commentators. Coming shortly after Monitor announced the establishment of the 100th FT, taking the proportion of FTs to 43% of all NHS acute trusts and 52% of mental health trusts[1], this seemed an opportune time to examine both the impact of the FT programme and their regulator.

2.  Unlike the Committee's usual inquiries, this one-off evidence session was not accompanied by formal terms of reference or a call for written evidence, although we received a number of written submissions. The scale and scope of our inquiry was therefore necessarily limited. However, given the importance of this set of reforms to the performance of the NHS as a whole, and given the surprising lack of published research evidence in this area, we have decided to publish a brief report outlining our findings. Alongside this report we are also publishing the written and oral evidence we received together with a list of further reading.[2]

3.  We took oral evidence from Dr Mark Exworthy, Reader in Public Management and Policy, School of Management, Royal Holloway, University of London; Dr John Carrier, Chairman, Camden PCT; Keith Palmer, Chairman, Barts and the London NHS Trust; Richard Gregory, Chairman, Chesterfield Royal NHS Foundation Trust; Stephen Firn, Chief Executive, Oxleas NHS Foundation Trust; and Dr Bill Moyes, Executive Chairman, Monitor. We are extremely grateful to our witnesses and to all those who submitted written evidence. We are also indebted to Alan Maynard, our Specialist Adviser, for his advice.

4.  In our questioning of witnesses, our main focus was on the impact of FT status, first on those trusts that have achieved FT status, and secondly on the wider NHS. Thirdly, and linked to both these questions, we considered FTs' accountability and autonomy, and the role of Monitor. This short report is divided into these three sections.

1  Back

2   We have also made use of the small amount of relevant research in this area, including 'Foundation Trusts in the NHS: does more freedom make a difference?' Marini et al, Health Policy, University of York, 2007 and Healthcare Commission and Audit Commission, Is the Treatment Working, May 2008 Back

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Prepared 17 October 2008