Foundation Trusts

Accountability Democracy

The Co-operative Party are proposing an amendment to Labour’s Health Policy see the Your Britain website.

Insert on pg 6 at line 42:
“In 2003 the previous Labour government established Foundation Trust Hospitals in England with the aim of making hospital services more accountable to local communities by giving Trust members a real say over their running. Ten years on the consensus is that, whilst more than 2 million people are members of Foundation Trusts, the model has not achieved its full potential and there is a need to re-awaken the original ambition behind it. One Nation Labour believes in more ‘people-powered’ public services and so a future Labour Government will consider ways of strengthening the role of members within Foundation Trusts and work to better engage and involve NHS staff in Trust membership.”

We’ve never been very comfortable with the ideas around Foundation Trusts.  In 2010 we agreed a statement including these words:

  • Local NHS facilities should remain publicly owned and Foundation Trusts should be a model for community multi stakeholder ownership.
  • The governance structures within which Foundation Trusts operate are flawed and are insufficiently undemocratic and must be extensively reformed.
  • Both purchasers and providers should be responsive to their local community and commissioning of services should be under proper democratic control
  • Whilst we accept that there will be a major increase in the number and scale of Foundation Trusts we do not accept denationalisation. Foundation Trusts must remain clearly part of the NHS family with a duty of partnership with both commissioners and other NHS partners. There must be explicit restrictions on sale and use of assets, on varying terms and conditions of employment and on non NHS income.

Our statement went on to propose a long list of improvements we wanted to see in the governance of Foundation Trusts. Things haven’t improved since.  Although many of our members are involved in Foundation Trusts, as members, governors, employees and board members, few seem convinced that the present model has much to be said for it. If we move away from the idea that each NHS Trust is competing in a market with all the other Trusts then perhaps this is not the place for a democratic voice?