Foundation Hospitals/sources

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• Milburn to give top hospitals power to run own affairs.   Guardian Tuesday January 15, 2002
• The health secretary, Alan Milburn, defended plans to give greater freedom to top performing hospitals and primary care trusts.  Guardian Unlimited Wednesday January 16, 2002
• Milburn outlines plan for quasi-independent hospitals.  Simon Parker Society Wednesday May 22, 2002
• Milburn invites best hospitals to vie for freedoms from Whitehall.  Simon Parker Society Thursday July 25, 2002
• Alan Milburn is poised to impose controversial supervisory boards to oversee management of the NHS's new foundation hospitals as a solution to the conflicting demands of democratic accountability and greater efficiency in Britain's healthcare system.  Michael White, political editor Guardian Wednesday August 7, 2002
• Dobson lays into hospital changes.  Michael White, political editor Guardian Thursday August 8, 2002
• Former Labour health secretary, Frank Dobson, last night weighed into the row between his successor, Alan Milburn, and the chancellor, Gordon Brown, with an attack on Mr Milburn's plans to establish free-standing foundation hospitals within the NHS.  Guardian Thursday August 8, 2002
• An official blueprint for the introduction of radical changes to the NHS and social services over the next three years, including the establishment of self-governing foundation hospital trusts and an expansion in the number of private health providers, emerged today.  Patrick Butler Wednesday October 2, 2002
• NHS to cushion foundation hospital loans.  Simon Parker Society Wednesday October 9, 2002
• Q&A: foundation trusts.  We explain the latest 'third way' from the government; hospitals free from the shackles of Whitehall control and excessive central bureaucracy.  Patrick Butler and Simon Parker Society Wednesday October 9, 2002
• New hospitals, old problems.  Malcolm Dean Wednesday October 16, 2002 The Guardian
• One of Labour's most trusted former generals accuses the party of cheating the poor to help the rich.  Frank Dobson  Sunday November 3, 2002 The Observer
• New plans for university top-up fees and foundation hospitals pander to snobs, argues former health secretary. Gaby Hinsliff, chief political correspondent Sunday November 3, 2002 The Observer
• Dobson's charges must be answered. Leader Monday November 4, 2002 The Guardian
• The government stepped up its commitment to NHS and social care reform with its announcement in the Queen's speech today of three bills to create foundation trusts, tackle bedblocking and modernise health bodies in Wales. Wednesday November 13, 2002
• Q&A: foundation trusts.  We explain the latest 'third way' from the government: hospitals free from the shackles of Whitehall control and excessive central bureaucracy? Or the first step to privatisation? Patrick Butler and Simon Parker Wednesday November 13, 2002
• The health secretary, Alan Milburn, today announced plans to tackle the "democratic deficit" in the health service by handing elected members of the public wide-ranging control over new foundation hospitals.  Simon Parker Thursday November 14, 2002
• Frank Dobson, the former health secretary, yesterday set himself at the forefront of a Labour backbench rebellion against the government's controversial foundation hospitals when he condemned them as a Tory idea.  Nicholas Watt, political correspondent Friday November 15, 2002 The Guardian
• Hospitals must not get special treatment.  Leader Friday November 15, 2002 The Guardian

• Wales goes own way with NHS reform.

  The devolved government of Wales has rejected New Labour's policy of creating autonomous foundation hospitals, arguing that it undermines the health service concept of universal provision.  Instead, the first minister, Rhodri Morgan, stressed yesterday, Wales was pursuing a different reform of making the service more accountable to communities and of treating patients as partners. He made clear that a "consumerist" agenda pursued by the government in England had little relevance in Wales. Peter Hetherington, regional affairs editor  Friday November 15, 2002 The Guardian
• Tony Blair's plans to create self-governing foundation hospitals were the subject of a two-pronged attack last night by senior Labour backbenchers, who warned that the new organisations would tout for private business abroad, and would end up being run by a group of 'self-selecting middle-class busybodies'.  Jo Revill, health editor Sunday November 17, 2002 The Observer
• Your leader (November 15) on foundation hospitals has misled your readers.  Letter Tuesday November 19, 2002 The Guardian
• Keep your nerve: this is the rebirth of popular socialism/  NHS foundation trusts aren't elitism, but localised public ownership Ian McCartney Monday December 2, 2002 The Guardian
• Popular socialism's rebirth (cont).  Letters Tuesday December 3, 2002 The Guardian
• Alan Milburn, the health secretary, will today offer an olive branch to the chancellor Gordon Brown in their battle over the future shape of the NHS when he announces that foundation hospitals will not be allowed to take in unlimited numbers of private patients. Wednesday December 11, 2002
• A backbench Labour rebellion against the government's health service reforms looked certain after 94 of the party's MPs last night put their name to a motion critical of NHS foundation trusts. Friday December 13, 2002
• False start.  An early draft of health secretary Alan Milburn's foreword to last week's Guide to NHS Foundation Trusts reveals more about the minister's thinking than he decided was wise to publish. Peter Davies rescued it from the Department of Health's dustbin... Thursday December 19, 2002
• Concessions by the health secretary, Alan Milburn, yesterday failed to soothe a large group of Labour backbench opponents of foundation hospitals, led by the former health secretary, Frank Dobson.  Patrick Wintour and John Carvel  Thursday January 9, 2003  The Guardian
• Hospitals aren't shops, and patients aren't customers.  In the health service, as in education, internal markets lower standards.  Polly Toynbee Wednesday January 29, 2003 The Guardian
•  Foundation for local ownership in the health service.  Letters Friday January 31, 2003 The Guardian
• Ex-minister slams 'elite' NHS trusts.  Patrick Butler Wednesday February 12, 2003 The Guardian
• Alan Milburn, the health secretary, is to confront his critics by suggesting that as many as 50 NHS hospitals could achieve foundation status independent of central government controls by the next election.  Patrick Wintour, chief political correspondent Friday February 21, 2003 The Guardian
• Two health initiatives were reported yesterday - the first, a restructured GP contract, could revitalise primary care; the second, an expansion of foundation hospitals, is an unwanted diversion.  Leader Saturday February 22, 2003 The Guardian
• Council leaders today joined the rising tide of opposition to the plans for semi-autonomous foundation hospitals, claiming that the new organisations would "perpetuate and rigidify" the lack of cooperation between local government and the NHS.  Simon Parker Tuesday February 25, 2003
• Split as NHS trusts bid for new freedom.  Jo Revill Health, editor Sunday March 2, 2003 The Observer
• Alan Milburn, the health secretary, will face searching questions today about whether his plan to set up foundation hospitals will damage collaboration in the NHS and introduce bogus accountability.  Patrick Wintour and John Carvel Tuesday March 4, 2003 The Guardian
• All hospitals 'could see regime change'.  David Batty Tuesday March 4, 2003
• 116 MPs have signed a Commons early day motion against plans for semi-autonomous NHS trusts. The full text of the motion, and its signatories, are as follows.  Tuesday March 4, 2003
• False foundations.  Hospital plans are the wrong priority,  Leader Wednesday March 5, 2003 The Guardian
• Foundation status chance for all hospitals.  Plans will not create an elite, says under-fire health secretary.  Patrick Wintour, chief political correspondent Wednesday March 5, 2003 The Guardian
• Alarm at NHS 'companies'.  Milburn's bill sparks Labour backlash.  Kevin Maguire, Larry Elliott and Michael White Saturday March 8, 2003 The Guardian
• Tony Blair has vetoed a plan by the health secretary, Alan Milburn, to call foundation hospitals "companies" in an attempt by Downing Street to defuse a Labour revolt over the creation of the self-governing institutions.  Kevin Maguire Wednesday March 12, 2003 The Guardian
• The government today flouted backbench opposition by publishing legislation to pave the way for a new generation of controversial NHS "super hospitals". Simon Parker Thursday March 13, 2003
• The government acted to head off a growing backbench rebellion against its NHS legislation last night by severely curbing the independence and powers of foundation hospitals. John Carvel, social affairs editor Friday March 14, 2003 The Guardian
• Freedom to set local targets excites trust. Martin Wainwright Friday March 14, 2003 The Guardian
• John Carvel reports on why, despite devils in the detail, foundation status for hospitals can still break Whitehall shackles. Wednesday March 19, 2003 The Guardian
• Tony Blair is to try to stem the rising opposition to foundation hospitals. Downing Street and the TUC are organising a meeting, perhaps next week, between the prime minister and the leaders of some of Britain's biggest unions. Kevin Maguire Thursday March 27, 2003 The Guardian
• Ministers could improve some public services by setting up public interest companies on the model of NHS foundation trusts, the left of centre thinktank the Institute of Public Policy Research will propose this week. Patrick Wintour, chief political correspondent Tuesday April 22, 2003 The Guardian
• The new leader of Britain's third largest union today warns Tony Blair of "huge fights" on private finance in public services, foundation hospitals and pensions. Jackie Ashley Monday April 28, 2003 The Guardian
• Foundation hospitals are a "Trojan horse for Sedgefield privatisers and Darlington money changers", a Labour MP warned today. Tuesday April 29, 2003
• The recently published bill for the establishment of NHS foundation trusts heralds the creation of the first new form of business organisation to be legally recognised in more than a century: the public benefit corporation (PBC). Wednesday April 30, 2003
• MPs finalised a critical report last night on the government's plans to create free-standing NHS foundation hospitals, as Tony Blair and Alan Milburn launched a fresh drive to quash next week's threatened Labour rebellion. Michael White, Kevin Maguire and John Carvel Wednesday April 30, 2003 The Guardian
• Q&A: foundation hospitals. Labour backbenchers are promising a big rebellion over government plans for foundations hospitals. But what exactly are they and how will they affect patients? Tash Shifrin reports. Wednesday April 30, 2003
• Labour's internal row over NHS reforms last night escalated into an ideological battle for the soul of the party as both sides opted to turn foundation hospitals into a symbol of the Blair government's future direction. Michael White, Heather Stewart and John Carvel Thursday May 1, 2003 The Guardian
• Milburn should pilot hospital changes. Leader Thursday May 1, 2003 The Guardian
• Blair's foundation hospital plans may bring backbench revolt. Includes comments from other newspapers. Friday May 2, 2003 The Guardian
• The shadow health secretary, Liam Fox, yesterday signalled plans to vote down Labour's foundation hospitals bill next Wednesday as he accused the chancellor of emasculating the government's original plan. Patrick Wintour and Michael White Friday May 2, 2003 The Guardian
• The rebels have won. Foundation hospitals were seen as privatisation by stealth. But when the lion roared, it brought forth a mouse. Polly Toynbee Friday May 2, 2003 The Guardian
• How important is this week's foundation hospitals debate? Will the government's plans save or ruin the NHS - or will other issues do more to determine the future health of the nation? The Observer asked a selection of experts and campaigners for their views. Franziska Thomas and Sunder Katwala Sunday May 4, 2003
• Every hospital in England and Wales will be able to apply for controversial foundation trust status by 2008, Tony Blair pledges today, despite criticisms that the new 'super-hospitals' will lead to a two-tier National Health Service. Kamal Ahmed and Gaby Hinsliff Sunday May 4, 2003 The Observer
• Hospital plan can save NHS. Freedom could liberate health services. Leader Sunday May 4, 2003 The Observer
• Observer comment extra. Why Labour MPs must back reform. The foundation hospitals row goes to the heart of an emerging split within the Labour Party. This week's vote could be the Clause Four of the welfare debate. David Green Sunday May 4, 2003
• NHS is being railroaded.  Larry Elliott Monday May 5, 2003 The Guardian
• The government has axed a scheme to save up to £500m a year in NHS administration costs because it clashes with Tony Blair's controversial plan to give all hospitals foundation status within five years. John Carvel and Nicholas Watt Monday May 5, 2003 The Guardian
• Public service hiccups. The rows have only just started. Leader Tuesday May 6, 2003 The Guardian
• Foundation of inequality. Letters Tuesday May 6, 2003 The Guardian
• Tony Blair and his health secretary, Alan Milburn, will warn rebel Labour MPs tomorrow that if they fail to embrace the concept of NHS foundation hospitals they risk repeating the party's historic mistake - far more ruthless reform at the hands of the Tories. Michael White and John Carvel Tuesday May 6, 2003 The Guardian
• Foundation hospitals legislation highlights divisions between Blair and his party. Opinions in other newspapers. Tuesday May 6, 2003 The Guardian
• Ministers today stepped up efforts to head off a backbench rebellion over plans to create semi-autonomous hospitals by unveiling an extra £200m to help poorer performing NHS trusts attain foundation status. Tuesday May 6, 2003
• Government attempts to consumerise public services with controversial new policies such as foundation hospitals may create high public expectations that can never be satisfied, policy specialists warn today. Simon Parker Tuesday May 6, 2003
• Tony Blair warned Labour MPs today not to make a "mistake of historic proportions" by voting against the creation of foundation hospitals tomorrow.  Tuesday May 6, 2003
• Those leading the project to unify NHS finance and IT operations to cut costs believe it is being sacrificed by plans to give hospitals more independence, writes John Carvel. Tuesday May 6, 2003
• Foundation hospitals will kill the NHS. Don't be fooled by the rhetoric: this is about privatisation. Allyson Pollock Wednesday May 7, 2003 The Guardian
• Foundation hospitals may enhance inequality in the NHS and encourage aggressive staff poaching in urban areas, the Commons health select committee will warn today as MPs prepare for the key parliamentary vote on the plans. John Carvel, social affairs editor Wednesday May 7, 2003 The Guardian
• What the papers say. The divisions in parliament over foundation hospitals are mirrored in the British press but while some regard the plans as a threat to NHS values, the majority think they are not radical at all. Wednesday May 7, 2003
• The Labour revolt against Alan Milburn's plans to create flagship foundation hospitals within the NHS was faltering last night as would-be rebels decided to hold their fire until they can amend the controversial bill in detail. Michael White and John Carvel Wednesday May 7, 2003 The Guardian
• Organisations representing NHS staff and health thinktanks give their views on the government's reform plans. Wednesday May 7, 2003
• NHS reform: the issue explained. Labour has promised to create an NHS for the 21st century, investing record sums to try to achieve its vision of a dynamic publicly-funded, consumer-driven health service. Patrick Butler reports. Wednesday May 7, 2003
• Letters of the week. Thursday May 8, 2003 The Guardian
• Up to 63 Labour MPs last night defied Tony Blair's direct appeal to back the government's blueprint for free-standing non-profit NHS hospitals in one of the biggest domestic rebellions since Labour was elected in 1997. Michael White, political editor Thursday May 8, 2003 The Guardian
• Cook falls in line with foundation hospitals, while former health secretary criticises 'upheavals'. Sarah Hall, Patrick Wintour and Michael White Thursday May 8, 2003 The Guardian
• Shaky foundations. The new hospitals need close monitoring. Leader Thursday May 8, 2003 The Guardian
• Labour rebels failed to block the government's plan to set up foundation hospitals. After a day of arm twisting and persuasion, involving the prime minister himself, the rebels' bid was defeated by 297 votes to 117. Thursday May 8, 2003
• Comments from various newspapers on the Labour votes against foundation hospitals. Friday May 9, 2003 The Guardian
• Price of entry will be our NHS. Bill Morris, general secretary of the TGWU, warns that healthcare will be a casualty of the currency. Sunday May 11, 2003 The Observer
• The post of independent regulator for NHS foundation trusts, potentially one of the most powerful jobs in the health service, has been advertised at a salary that could top £175,000. Tash Shifrin Wednesday May 14, 2003
• The government today named 29 NHS trusts as candidates to become the first wave of foundation hospitals. The full list is as follows. Wednesday May 14, 2003
• Tony Blair is facing an embarrassing defeat at Labour's annual conference over plans to press ahead with the creation of foundation hospitals despite widespread opposition. Kevin Maguire Saturday May 17, 2003 The Guardian
• Government plans for improving public services could founder as ministers pour money into new devolved organisations such as foundation hospitals that might not be able to cope, the audit commission warned today. Simon Parker Tuesday May 27, 2003
• How will plans for foundation hospitals be put into action - and will NHS executives start managing differently? Simon Caulkin reports. Wednesday May 28, 2003 The Guardian
• At least three of the NHS hospitals being groomed by ministers for foundation status are too weak to manage outside the control of Whitehall, the government's spending watchdog warned yesterday. John Carvel, social affairs editor Thursday June 5, 2003 The Guardian
• Labour backbenchers have accused ministers of changing legislation on foundation hospitals to allow them to avoid a "cap" limiting the amount of private operations they carry out. Tash Shifrin Friday June 6, 2003
• Will the new foundation hospitals wreck coordination of local health and social care provision? Martin Wainwright investigates. Wednesday June 25, 2003 The Guardian
• Cabinet ministers were accused yesterday of secretly planning the privatisation of foundation hospitals in a valedictory blast from Sir Bill Morris, the outgoing leader of the Transport and General Workers Union. Kevin Maguire Monday June 30, 2003 The Guardian
• Government plans to establish NHS foundation hospitals have met with fierce opposition. Why? Monday June 30, 2003 The Guardian
• John Reid yesterday began a concerted move to tone down the significance of NHS foundation trusts in preparation for concessions ahead of Tuesday's expected large backbench revolt at the report stage to establish such trusts. Patrick Wintour, chief political correspondent Wednesday July 2, 2003 The Guardian
• This is not a cure for the NHS. Foundation hospitals will spell political disaster for Labour. Frank Dobson Tuesday July 8, 2003 The Guardian
• Rebels without a cause. Hospitals are not the big issue in the NHS. Leader Tuesday July 8, 2003 The Guardian
• Ministers are to give local authorities a seat on the board of foundation hospital trusts, as part of a package of concessions aimed at heading off a backbench rebellion over the health and social care bill today. Tash Shifrin Tuesday July 8, 2003
• Q&A: foundation hospitals' Labour backbenchers are promising a new rebellion over government plans for foundations hospitals. But what exactly are they and how will they affect patients? Tash Shifrin reports. Tuesday July 8, 2003
• Government rejects MPs' foundation concerns. Tash Shifrin Tuesday July 8, 2003
• The government's majority plunged to just 35 today as Labour rebels narrowly failed to block the government's controversial plans to set up foundation hospitals. Tuesday July 8, 2003
• Foundation hospitals return healthcare to the public. Letters Wednesday July 9, 2003 The Guardian
• Labour's majority slumps to 35 in hospitals vote. Government survives thanks to Scottish and Welsh MPs. Michael White, political editor Wednesday July 9, 2003 The Guardian
• Tony Blair appealed yesterday to Labour MPs not to let party indiscipline destroy their chances of a historic third term in power, as rebellious backbenchers turned their attention from NHS foundation hospitals to the equally contentious issue of student tuition fees. Michael White, political editor Thursday July 10, 2003 The Guardian
• Did you know that Britain has tried foundation hospitals before? Stephen Cook meets historians whose research could and should help us to learn health lessons from the past. Tuesday July 22, 2003 The Guardian
• Tony Blair will use his last press conference before departing for his Caribbean holiday to announce plans to more than double the size of the controversial foundation hospitals programme. Patrick Wintour, chief political correspondent Wednesday July 30, 2003 The Guardian
• The prime minister today announced plans to more than double the size of the controversial foundation hospitals reform programme, prompting criticism from the scheme's opponents. Wednesday July 30, 2003
• The government's method of selecting foundation hospitals was condemned as a fraud yesterday after the Liberal Democrats exposed glaring inconsistencies in the official data of the NHS.  John Carvel, social affairs editor Tuesday August 5, 2003 The Guardian
• Frank Dobson, the former health secretary, is making an unprecedented attempt from the Labour backbenches to incite a mutiny in the House of Lords against the government's plans to establish foundation hospitals free from ministerial control.  John Carvel, social affairs editor Monday September 8, 2003 The Guardian
• The TUC yesterday condemned government plans to create free-standing foundation hospitals in England as establishing a two-tier health service and paving the way for wholesale privatisation of the NHS. David Gow Thursday September 11, 2003 The Guardian
• The leader of Britain's 120,000 doctors made the fiercest attack yesterday on government plans for foundation hospitals to come from the profession. John Carvel Friday September 26, 2003 The Guardian
• The health secretary, John Reid, today admitted that foundation hospitals are an experiment and that he has no clear idea how the controversial project will work out in practice. Helene Mulholland Thursday September 25, 2003
• More than £2.5 million of NHS money is being spent on glossy documents and public consultations by the country's top-performing hospitals in their bid to become foundation trusts. Jo Revill, health editor Sunday September 28, 2003 The Observer
• Labour's high command was last night facing the prospect of a growing schism between Tony Blair's government and the "big four" unions after a day of tactical manoeuvring at the Bournemouth conference ended with a crushing defeat on foundation hospitals - but a reprieve on Iraq. Michael White and Patrick Wintour Thursday October 2, 2003 The Guardian
• Foundations a factor as Hinchcliffe quits Commons. Tash Shifrin Friday October 3, 2003
• The government has today announced the names of a second wave of foundation hospital applications as it attempts to steer controversial legislation to create the new organisations through the House of Lords. Tash Shifrin Tuesday October 7, 2003
• The second wave of NHS trusts applying for foundation status. Despite backbench and union opposition, the government has announced the names another 32 hospitals who have applied for foundation status as it attempts to steer controversial legislation to create the new organisations through the House of Lords. Twenty-five hospitals are already involved in the application process. Tuesday October 7, 2003
• Q&A: foundation hospitals.  The legislation which would introduce controversial foundation hospitals is being debated in the Lords. Tash Shifrin explains the background. Wednesday October 8, 2003
• Thousands of residents in Islington and Camden appear to be receiving leaflets inviting them to become "members" of UCLH foundation trust - even though foundation trusts are not yet law. The leaflet tells potential members that they will receive no special "privileges" or preferential treatment, but then goes on to list Bupa-like benefits, including "discounted health checks". We always thought free health checks were one of the universal benefits of an NHS funded by taxation. Is one of the special benefits of trust membership that you get to pay twice for healthcare? This is an early and stark example of how foundation trusts would blur the distinction between the NHS and private medicine. Be warned. Dr Fiona Campbell Democratic Health Network. . Letters Friday October 17, 2003 The Guardian
• Tony Blair's legislative logjam is set to worsen today as peers combine to throw out his controversial plans for foundation hospitals. Sarah Hall Thursday November 6, 2003 The Guardian
• The government faces a further fight in the Commons on its foundation hospital legislation which was humiliatingly thrown out yesterday by the House of Lords. Sarah Hall, political correspondent Friday November 7, 2003 The Guardian
• The row over foundation hospitals is as curious as it is furious. With so much to argue about over the government's plans to change the character of the NHS, the puzzle is why massive political attention is consistently given to the foundation plan, to the exclusion of more important matters. Wednesday November 12, 2003 The Guardian
• The sick can't shop around. The government's health service reforms represent a triumph of dogma over evidence. Roy Hattersley Friday November 14, 2003 The Guardian
• The leader of Britain's doctors called on the government yesterday to drop its controversial plans for foundation hospitals when the health bill returns to the Commons on Wednesday after a mauling in the Lords. John Carvel, social affairs editor Saturday November 15, 2003 The Guardian
• Former health secretary Frank Dobson has written to Labour MPs urging them to throw out the government's plans for foundation hospitals when the health bill returns to the Commons on Wednesday. John Carvel Friday November 14, 2003
• Improving patient care. Letters Tuesday November 18, 2003 The Guardian
• It's Labour's rebels who block choice. The critics are wrong - foundation hospitals trust patients to decide. John Reid Wednesday November 19, 2003 The Guardian
• Q&A: foundation hospitals. MPs today backed the government's controversial plans to establish foundation hospitals by 302 votes to 285, with a much-reduced Labour majority. Tash Shifrin explains more. Wednesday November 19, 2003 John Reid, the health secretary, was forced to offer an independent review yesterday of the impact of foundation hospitals as he averted a defeat in the Commons on the government's flagship legislation. Patrick Wintour, chief political correspondent Thursday November 20, 2003 The Guardian
• Modest foundations. Leader Thursday November 20, 2003 The Guardian  
• The government finally won its long battle to bring in foundation hospitals today, after recalcitrant peers gave up their opposition on the final day of the parliamentary session. Matthew Tempest and agencies Thursday November 20, 2003
• No foundation for health' Friday November 21, 2003 The Guardian
• The Department of Health circulated private plans to respond in the event of a defeat on foundation hospitals by introducing many of the proposed freedoms through an executive order, a leaked memo revealed yesterday. Patrick Wintour, chief political correspondent Friday November 21, 2003 The Guardian
• The health secretary, John Reid, today rebranded a second wave of would-be foundation hospitals as wave "1a" in a bullish speech signalling the government's intention to drive forward the controversial policy without delay. Tash Shifrin Tuesday November 25, 2003
• The Department of Health was still unable to specify what the governance arrangements for foundation hospitals will be on the eve of a meeting between first-wave foundation heads and health secretary John Reid. Tash Shifrin Tuesday November 25, 2003
• The health secretary, John Reid, infuriated his Labour backbench critics yesterday by more than doubling the number of NHS hospitals that will gain foundation status next year. John Carvel, social affairs editor Wednesday November 26, 2003 The Guardian
• The head of a retail industry organisation has been appointed as the independent regulator for foundation hospitals - set to be one of the most powerful jobs in the NHS. Tash Shifrin Thursday December 4, 2003
• The government appointed a banker as the regulator of the first wave of foundation hospitals last night, prompting criticism that health ministers were more concerned about finances than improving patient care. John Carvel, social affairs editor Thursday December 4, 2003 The Guardian
• The Department of Health's plan for foundation hospitals to organise elections to their governing bodies was in chaos last night as local NHS chiefs warned they were open to takeover by Trotskyists and other extremist groups.  John Carvel, social affairs editor Wednesday January 21, 2004 The Guardian
• Foundation hospitals are starting the election process to find governors. But has enough time been left for Labour's great democratic experiment to work? John Carvel reports. Wednesday January 21, 2004 The Guardian
• Half of the hospitals applying for NHS foundation status in April 2004 will have to wait until July to have their applications approved.  Orla Delargy Wednesday February 4, 2004
• Q&A: foundation hospitals. The government has succeeded in getting foundation hospitals through parliament despite fierce opposition. But just as the first wave were set to come into existence, in steps the regulator to hold back half for extra checks. Tash Shifrin fills in the gaps. Wednesday February 4, 2004
• Chief executives of local NHS trusts are being cajoled into signing legally binding contracts to supply foundation hospitals with a guaranteed flow of patients before the terms have been properly negotiated, a Department of Health document has revealed. John Carvel, social affairs editor Thursday March 18, 2004 The Guardian
• Q&A: foundation hospitals. As the government announces the first 10 NHS hospitals to become foundation trusts, opponents of the new organisations renew their claims that they will create a two-tier health service. Tash Shifrin and David Batty explain more .Wednesday March 31, 2004
• First 10 hospital trusts granted their freedom from Whitehall. Reid promises others will get chance in next five years. James Meikle, health correspondent Thursday April 1, 2004 The Guardian
• Patients as guests, payment by results ... death-knell of the NHS? John Carvel Thursday April 1, 2004 The Guardian
• Only 20,000 people voted in elections for control of the first 10 foundation hospitals, serving more than 2 million NHS patients, according to a survey for Society Guardian. John Carvel, social affairs editor Wednesday April 7, 2004 The Guardian
• Health service staff in Bradford, Doncaster and Chester who are blessed with long memories might have wondered last week whether they were the subject of some elaborate April fool's day joke as their hospitals were named among the first to be granted self-governing foundation status. These three institutions were among the first to become self-governing NHS trusts on the very same day 13 years ago. Then, the talk was of a promised land where trusts could flourish free of the heavy hand of Whitehall. Now, talk is of an identical promised land, still shimmering on the horizon but seemingly no nearer. Peter Davies Thursday April 8, 2004
• Tony Blair's plans to give all NHS hospitals foundation status within four years were set back yesterday when England's premier orthopaedic hospital was declared unfit to gain independence from Whitehall control. William Moyes, the independent regulator of foundation trusts, struck the Nuffield Orthopaedic Centre, Oxford, from the list of top hospitals that ministers wanted to form the vanguard of the programme. He said the centre could not demonstrate how it would remain viable in the long-term after the government introduced a new system of payment by results. The implication was that hospitals specialising in more costly and complex medical procedures might go bust under the new scheme. John Carvel, social affairs editor Thursday July 1, 2004 The Guardian
• The health secretary, John Reid, today staged a press conference to set the announcement of 10 more foundation hospitals in the context of a renewed government offensive on patient choice. Tash Shifrin and agencies Thursday July 1, 2004
• Individual NHS doctors and nurses will pocket bonus payments worth hundreds of pounds for carrying out extra operations, health minister John Hutton announced today. The following 32 trusts have been selected to pilot the fee-for-service scheme . Friday July 9, 2004
• Two of the elite group of hospitals that became independent foundation trusts this year are to be stripped of their three-star status today in a move that casts doubt on the government's plans for NHS reform. John Carvel, social affairs editor Tuesday July 20, 2004 The Guardian
• The health secretary, John Reid, has strongly denied speculation that the foundation hospital programme was in chaos following today's publication of NHS league tables. Mr Reid defended the policy following the annual performance ratings published today by independent inspectorate the Healthcare Commission, which showed that one third of the 31 trusts expecting to gain foundation status over the next few months had been stripped of their required three-star ratings. Hélène Mulholland Wednesday July 21, 2004 .  The article links to the various star ratings.
• There is much that is crude and deficient about the star-ratings system for NHS trusts (Foundation hospitals plan left in chaos, July 21). However, it is a concern that at least three of the four new foundation trusts that lost a star were marked down because of "poor financial forecasting". Alongside more local participation in health issues, greater financial independence and the freedom to borrow were sold as "benefits" for NHS trusts attaining foundation trust status. Wouldn't financial forecasting be one of the key skills required to borrow and invest in the interests of patients? This debacle suggests that the whole foundation trust issue needs to be revisited. Dr Fiona Campbell Democratic Health Network Thursday July 22, 2004 The Guardian
• Foundation hospitals in England are to be exempt from NHS rules banning the poaching of nurses and other medical staff from developing countries, a confidential Department of Health document has revealed. A draft code of practice seen by the Guardian says foundation trusts will be treated like private hospitals and merely "invited" to adopt ethical recruitment policies, without any sanction if they choose to ignore them. For other NHS organisations - and UK employment agencies that supply them with staff - the rules will be compulsory. John Carvel, social affairs editor Monday July 26, 2004 The Guardian
• Unions have today reacted with astonishment at the "shameful" u-turn on poaching nurses from developing countries, just two months after the health secretary, John Reid, pledged to strengthen the code of conduct on ethical recruitment. The erosion of the code of conduct on international recruitment comes as hospitals with foundation status are to be exempt from a statutory obligation to adhere to the guidance. Hélène Mulholland Monday July 26, 2004
• Five hundred hospital jobs are to go in two hospital trusts whose bids for foundation status were thwarted last month. Southampton University hospitals trust and Winchester and Eastleigh healthcare trust both applied to be in the autumn wave of foundation trusts, alongside 32 other trusts. Hélène Mulholland Thursday August 5, 2004
• The government promised yesterday to close loopholes that have allowed NHS hospitals to poach thousands of nurses and doctors from developing countries with a shortage of medical staff. John Hutton, the health minister, said he would stop NHS organisations evading a code of practice that was brought in three years ago to stop unethical recruitment. But the Royal College of Nursing said the problem would not be solved unless the ban was extended to the private sector. John Carvel, social affairs editor Thursday August 26, 2004 The Guardian
• The Department of Health's proposals on the recruitment of health workers (Minister to close loopholes, August 26) from the world's poorest countries are an improvement, but still ignore the main issue. Domestic agendas are overriding the need to tackle poverty. We should manage migration in a way that puts the needs of poor countries first. Letters Friday August 27, 2004 The Guardian
• The government recognises that it is unethical to poach nurses from sub-Saharan Africa. But kind words alone won't cure this problem. John Carvel Friday August 27, 2004 The Guardian
• Hospitals' results earnings could be capped. Hospitals could lose potential revenue worth millions of pounds under the rollout of a scheme to fund patient care, it has emerged. The Department of Health (DoH) today confirmed that it would consider capping hospitals for surplus earnings gained under payment by results (PBR), the latest piece of government policy to fund patient care. Hélène Mulholland Thursday August 26, 2004
• An NHS hospital in the first wave of hospitals to win foundation status yesterday admitted it was in "acute financial difficulties" and heading to make a £4m loss by the end of the financial year. The independent regulator of foundation trusts issued a formal notice requiring Bradford Teaching Hospitals to remedy a "significant" departure from the business plan, which he approved in the spring. Other NHS hospitals have got into deficit and were bailed out by the government with a supplementary allocation. But foundation trusts lost this leeway when they claimed the privilege of independence from Whitehall control. John Carvel, social affairs editor Thursday October 21, 2004 The Guardian
• Foundation hospitals will be publicly named and shamed if they fall short against three new "risk ratings" announced yesterday by their independent regulator. The hospitals, which adopted foundation status to break free from Whitehall control, were told they would be regularly measured on a triple scorecard, covering financial strength, clinical performance and management systems. Bill Moyes, the chairman of Monitor, the regulatory body, said they would be scored from one (good) to five (bad) on the state of their balance sheets. Using a traffic light system, they would be graded red, amber or green on the other aspects of performance. John Carvel, social affairs editor Friday November 5, 2004 The Guardian
• A financial crisis at one of the government's flagship foundation hospitals escalated yesterday when the independent regulator warned that its expected deficit has trebled over the past month to £11.3m. William Moyes, the chairman of Monitor, the foundation trusts' regulatory body, said Bradford Teaching Hospitals NHS trust hushed up its financial difficulties for four months until he found out about them in a routine accounting exercise in August. John Carvel, social affairs editor Saturday November 27, 2004 The Guardian
• The health secretary, John Reid, today gave foundation hospitals his vote of confidence and said there were no grounds for him to intervene in the case of one of them which is facing a predicted £11.3m deficit. Giving evidence to the Commons health select committee, Mr Reid said there was no "imminent" threat to patient services as a result of the Bradford teaching NHS trust's financial problems and so there was no reason for him to become involved. Wednesday December 8, 2004
• A survey showing that chief executives of foundation trust hospitals are finding the system too restrictive has cast doubt on Tony Blair's plan for all NHS hospitals in England to gain the status in a third Labour term. John Carvel, social affairs editor Monday December 13, 2004 The Guardian
• A Guardian survey of foundation hospitals has revealed widespread unease among the first 20 trusts to gain independence from Whitehall control. Their chief executives are disappointed they have not reaped the expected benefit of cuts in red tape. Most are enthusiastic about rules giving local people and staff a say in running the hospitals. But they are concerned about how little they are allowed to borrow, anxious about the future of "payment by results", and sceptical of Tony Blair's pledge that all acute hospitals should be in a position to claim foundation status by 2008. John Carvel, social affairs editor Monday December 13, 2004 The Guardian
• Foundation trusts spend hundreds of millions of taxpayers' money each year (Threat to Blair plan for NHS, December 13). Efficient and detailed systems of "red tape" are essential to ensure they deliver improved outcomes to patients. Even if Mr Blair privatises the hospitals, regulatory control will continue to be essential and, if the US health care system is Mr Blair's guide, the costs of "bureaucracy" will rise from the modest 5% of NHS expenditures now to the over 30% that has been demonstrated by American research. The current regulation of the NHS and all other healthcare systems, public and private, remains poor because of the absence of systematic measures of success in improving patient health. Perhaps the "pioneering" foundation trusts should take the lead in this, rather than agitate for increased levels of non-accountability for using taxpayers' scarce resources? Prof Alan Maynard Department of health sciences, University of York  Letter Tuesday December 14, 2004 The Guardian
• An unpublished proposal to prepare all NHS hospitals in England for independence from Whitehall by 2008 was revealed by the foundation hospitals regulator yesterday, in response to a Guardian survey questioning trusts' readiness to survive on their own. John Carvel, social affairs editor Tuesday December 14, 2004 The Guardian
• Former Labour health secretary Frank Dobson did an effective piece of stand-up at a recent conference on public services organised by the union-supported thinktank Catalyst. How many voters actually voted for the last representative to win a seat in the public's section of the governing body of University College Hospital, which is in his constituency in London? Dramatic pause. Answer: seven. Big laugh. Wednesday December 15, 2004 The Guardian
• A foundation hospital chairman was sacked by the independent regulator yesterday for failing to address his NHS trust's financial difficulties. John Ryan, chairman of Bradford Teaching hospitals, was removed for not producing a credible recovery strategy after accountants found a £11.3m hole in the accounts. John Carvel, social affairs editor Wednesday December 15, 2004 The Guardian
• The government yesterday lit a bonfire of NHS red tape and promised to halve form-filling by foundation hospitals whose irritation about bureaucracy was disclosed by the Guardian. Lord Warner, the health minister, said he was scrapping 61 types of data collection, including an obligation on foundation trusts to submit records of minor administrative matters such as car parking and laundry services. John Carvel, social affairs editor Saturday December 18, 2004 The Guardian
• The number of foundation trusts in England rose to 25 today after the government announced a further five NHS trusts were to be granted independent status. Five trusts - Barnsley hospital, Chesterfield royal hospital, Gateshead health, Harrogate and district and South Tyneside - successfully applied for foundation status, but a further four were either deferred or withdrawn. Tuesday January 4, 2005
• NHS leaders called yesterday for a government inquiry into whether foundation hospitals are admitting thousands more A&E patients for further treatment to increase their revenue under the new system of payment by results. The NHS Confederation, representing managers and trusts, said "perverse incentives" were being offered to hospitals to admit patients to a ward instead of treating them promptly and sending them home within the four-hour deadline set by ministers. Those admitted via A&E automatically trigger a £1,200 invoice to be paid by the patient's primary care trust, even if the patient is subsequently discharged in less than 12 hours. John Carvel Friday January 7, 2005 The Guardian
• You say that foundation hospitals are admitting "thousands more A&E patients for further treatment to increase their revenue" (Foundation hospitals challenged, January 7). In fact, foundation trusts' increase in admissions is not out of line with the rise in England as a whole. The reason is probably related to a very challenging target, which is intended to ensure that patients don't spend more than four hours in A&E. The way the payment- by-results system has been designed does create an incentive to improve the recording of admissions in all hospitals and is recognised as having some perverse incentives. But there is no evidence that this is a problem unique to foundation trusts. The NHS Confederation has not called for a government inquiry into foundation trusts' behaviour, but for a review to ensure that incentives and targets for all NHS organisations support the high-quality delivery of emergency care. Nigel Edwards NHS Confederation Sue Slipman Foundation Trust Network  Letter Monday January 10, 2005 The Guardian
• When New Labour came up with the idea that the best hospitals should control their own fortunes, no one foresaw the desperate plight that now faces the ailing Bradford Royal Infirmary.. Jo Revill Sunday January 16, 2005 The Observer
• The government's drive towards all hospitals achieving foundation status moved another step closer today when 32 more NHS trusts were invited to apply for the next wave. David Callaghan Tuesday January 18, 2005
• John Reid, the health secretary, made the first move yesterday to extend foundation hospital status into the field of mental health.. John Carvel Wednesday January 19, 2005 The Guardian
• The sacked chairman of one of the first foundation hospital trusts says he has been made a scapegoat for the failure of the flagship government policy, it has emerged. John Ryan also warned that other prospective foundation trusts face financial crisis, and that the whole government policy was "a mess". Debbie Andalo Wednesday January 19, 2005
• Up to five NHS foundation trusts are facing an "adverse financial position", it emerged today. But independent regulator Monitor, set up by the government to oversee foundation trusts, said none of them faced the same financial crisis as Bradford hospitals NHS foundation trust, which has a predicted £11m deficit. Debbie Andalo Thursday January 20, 2005
• The shortage of critical care beds in Warrington hospital, which led to the repeated postponement of Margaret Dixon's operation, has highlighted concerns among health professionals about lack of capacity in high-pressure sectors of the NHS. Owen Bowcott Saturday March 5, 2005 The Guardian
• Great Ormond Street is one of the wealthiest hospitals in the world. It is now in the middle of a multi-million pound redevelopment. Its fundraising campaigns are backed by celebrities and its old wards will be transformed within the next five years. Its pioneering care for sick children and authoritative expertise on anything from leukaemia to depression continues to win national and international acclaim. Yet despite all that the hospital doesn't have the money it needs to keep its beds open. The millions of pounds raised for the new development cannot be spent on daily running costs as the NHS does not allow such transfers of money. Many hospitals facing deficits would do as Great Ormond Street is - cancel operations, close beds and cut the nursing bill. They may not be so high profile, but every trust must balance its books. Great Ormond Street's deficit - £1.7 million - is tiny compared with the £184m spent each day on the NHS. But it must make itself as financially lean as possible to win the approval of the Health Secretary, John Reid, for it to become a foundation trust, cherished status that brings some independence. Jo Revill, health editor Sunday March 6, 2005 The Observer
• John Reid, the health secretary, will today ratchet up competition in the NHS by giving foundation hospitals in England an opportunity to attract extra patients from outside their normal catchment areas. John Carvel, social affairs editor Thursday March 17, 2005 The Guardian
• NHS hospitals will be allowed to advertise to attract patients in a competitive market in which doctors and nurses will never be sure how many people will choose to use their services, the Department of Health revealed yesterday. John Carvel, social affairs editor Friday March 18, 2005 The Guardian
• Readers surprised to see that NHS hospitals will be able to advertise (Report, March 18) should visit the website of the Mayo Clinic in the US, where they are invited to "find a disease". How much more in line with true patient choice it is to be able to "get something" directly from the hospital, which the doctors there presumably know how to diagnose and cure? Keith Baverstock Kuopio, Finland. Tuesday March 22, 2005 The Guardian
• Foundation trusts which are given a top credit rating will be able to borrow up to 40% of their capital assets to reinvest in services, according to a financial code published by the independent regulator Monitor. Each foundation trust will be given a financial risk rating of between one - for highest risk - to five for lowest risk. The ratings will be awarded according to the trust's three-year projected financial statement which has to be outlined in its annual plan submitted to Monitor every year. Debbie Andalo Thursday March 24, 2005
• Six more NHS hospitals were awarded foundation status yesterday but five others were told that they were not ready for self-governing. John Carvel Friday April 1, 2005 The Guardian
• Foundation hospitals are set to resurrect their fight for greater freedom to borrow in a report due to be published tomorrow. The Foundation Trust Network is to call for greater borrowing powers just three years after the chancellor, Gordon Brown, won a battle with the then health secretary, Alan Milburn, to keep borrowing by the stand-alone trusts on the government's books.  Hélène Mulholland Monday July 4, 2005
• The NHS is set to become a two-tier service with independent foundation hospitals attracting patients from less successful establishments that remain under government control, the health inspectorate warned yesterday. The warning confirmed the fears of Labour backbenchers who opposed the foundation experiment two years ago in one of the biggest Commons revolts in the last parliament. Anna Walker, chief executive of the independent Healthcare Commission, said it was unlikely that all NHS hospitals in England would be strong enough to apply for foundation status by 2008, as the government has promised. John Carvel, social affairs editor Wednesday July 6, 2005 The Guardian
• Four of the government's flagship foundation hospitals are projecting deficits of more than £3m, according to research published today. Bradford, Chester, Peterborough and Devon and Exeter foundation trusts are under serious financial pressure due to the cost of bringing in new funding arrangements and staff contracts, warned NHS inspectorate the Healthcare Commission. The commission revealed that the foundation trusts were hard hit by last year's introduction of the payment-by-results system. Under this scheme their NHS funding depends on the number of patients treated, with hospitals receiving a set sum for each treatment. David Batty Tuesday July 5, 2005
• A foundation hospital is using its freedom from Whitehall control to build up a chain of eye surgery "boutiques" in NHS hospitals across London. Moorfields NHS trust has capitalised on its international reputation for high-class ophthalmology to open branded clinics in 10 other general hospitals. It provides the surgeons, owns the equipment and controls the operating space to maintain clinical standards. John Carvel Social affairs editor Thursday October 13, 2005 The Guardian
• Sue Slipman, the director of the Foundation Trust Network, shrugs off her chameleon-like past to tell John Carvel of the importance of a 'level playing field' if ministers' plans for hospital reform are to come to fruition. Wednesday October 26, 2005 The Guardian
• A solid foundation for our hospitals. Letter Saturday November 5, 2005 The Guardian
• The number of hospitals permitted to apply for foundation status is set to double, after the government today announced that two-star trusts would be allowed to apply for the first time. Hélène Mulholland Monday November 7, 2005
• A world-famous London teaching hospital has become the latest victim of a financial crisis in the NHS. University College hospital was given a maximum risk rating yesterday by Monitor, the foundation trust regulator, after posting a £17.4m loss over the first six months of the financial year. It blamed part of the deficit on the terrorist bombings in London in July, which resulted in the loss of four days of normal activity, adding £2m to the deficit. UCLH already had clearance to declare a £6m deficit for 2005-06 to cover the cost of moving its main hospital. But Monitor was alarmed at an unexpected deterioration of the balance sheet between October and November, when not enough patients were treated and cost savings did not materialise. It declared the trust to be "failing to exercise its functions in an effective, efficient and economic way". The failings, it said, were "significant". John Carvel, social affairs editor Saturday December 17, 2005 The Guardian
• Watchdog refuses to back hospital rebuild. Monitor, the foundation hospital regulator responsible for scrutinising Birmingham's Queen Elizabeth Hospital, has refused to back a planned £550 million PFI rebuild. It raised concerns that the project depends on a £109m grant from the Department of Health, which has not yet been approved, that the cost of moving to new premises has not been fully considered and that necessary efficiency savings had not been taken into account. The Department of Health asked Monitor to endorse the scheme but it refused. The Treasury has also not yet approved the rebuild plan, despite having been expected to authorise it almost a year ago. Summary by Keep our NHS Public of  Birmingham Post 18 January 2006
• Treasury backed over scrutiny of variations in NHS performance. The Treasury presentation leaked to the Financial Times yesterday showed big variations in NHS performance across the country. Treatments at some hospitals cost 80% of the average, while at others the figure is 130%. There is a five-fold variation in the cost of emergency admissions between similar PCTs, suggesting differing quality of primary care, and a two-fold variation in length of hospital stays. While it is widely remarked that NHS productivity is falling, the measures used are not sufficient and have paradoxical effects. For example, not immunising for influenza would result in more hospital admissions and would appear to increase productivity. Summary by Keep our NHS Public of  Financial Times 18 January 2006
• NHS crisis - special report. A front page spread asks why the NHS is in financial crisis when its funding has doubled since 1997. It says half the money has gone on staff pay; huge amounts were spent because of a politically motivated focus on cutting waiting times at any cost before the last election; PFI hospitals have resulted in large yearly bills; and drug spending has doubled since 1997. Summary by Keep our NHS Public of  Independent 18 January 2006
• Fears mount over £1bn Mersey health plans. The £1bn plan for rebuilding the Royal Liverpool Hospital and Alder Hey children's hospital, as well as creating a major new health centre at Aintree Hospital, have been cast into doubt by the government's review of PFI projects. The Department of Health denies that it has put a hold on PFI as a policy, but it is looking again at whether schemes are affordable. The Mersey proposals are at an early stage, and work will continue on the formation of business plans. Summary by Keep our NHS Public of  Liverpool Daily Star 18 January 2006

• Hope for super-hospital as London plans axed. West Midlands SHA is standing by its plans for a £420m PFI hospital on the site of the University Hospital of North Staffordshire, despite the questions that surround the future of PFI. The deal with the Equion consortium would cost the local health economy £52m a year for the next three decades. More than £6 million of "enabling work" is already in progress. Summary by Keep our NHS Public of  Stoke Sentinel 18 January 2006

• Cash crisis threatens plans for more PFI hospitals. Two more hospital PFI schemes have been held up by fears over affordability - the Plymouth Hospitals Vanguard PFI project, with a value of £600m, and the Hillingdon Hospital in Uxbridge, West London, a £300m scheme. In the case of Plymouth, officials are questioning whether a proposed £200m care centre will be able to compete with enhanced GP surgeries and IS-TCs. Summary by Keep our NHS Public of  Times 18 January 2006

• Mental health trusts keen to be awarded foundation status. Five mental health trusts have been approved for foundation status by the Department of Health, despite questions over future funding under payment by results. Monitor will make the final decision on the applications in April. The workings of PbR have yet to be established for mental health, and there are difficulties in designing the system because mental health care is often provided over long periods and is more complex. Summary by Keep our NHS Public of Public Finance 20 January 2006
• Terms of PFI rewritten as insurance costs soar. The Treasury is rewriting the standard terms of PFI deals to make the private sector responsible for the cost of insurance. Since September 11 insurance costs have rocketed, and in PFI deals rates have often been well above the market level because public bodies have been in a weak bargaining position. Now the private contractors will have to include insurance costs in their bids, and absorb the first 30% of any rise in premiums thereafter. Summary by Keep our NHS Public of Public Finance 20 January 2006
• Foundations say tariff changes could scupper next applications. Foundation trusts have reacted angrily to the lower-than-expected 1.5% rise in the payment by results tariff, saying it will destabilise their financial planning and leave them with gaping holes in their accounts. Foundation Trust Network director Sue Slipman said she was angry and disappointed with the amount, and questioned whether the current batch of foundation trust applicants, set for authorisation in April and July, would now be viable because "trusts will have assumed a higher uplift and put that in their original business plans". Summary by Keep our NHS Public of Health Service Journal 9 February 2006
• Hospital fees rises hurt health finances. Norfolk's cash-strapped health trusts are objecting to being forced to pay above the odds for patients treated at Addenbrooke's Hospital, Cambridge. South Norfolk PCT's finance director Matt Colmer said that since the hospital introduced a payment by results the amount the PCT was paying had increased from £2.6m to £3.2m. The PCT, facing a deficit of £6.8m, previously had a block contract with Addenbrooke's. But the hospital introduced payment by results after becoming a foundation trust in 2004.  Summary by Keep our NHS Public of Eastern Daily Press 10 February 2006
• Merger heralds first 'academic foundation'. The UK's first 'academic foundation trust' could be established in London under a merger of St Mary's and Hammersmith Hospitals trusts. The merged trusts would enjoy an 'intimate' relationship with nearby Imperial College, an independent part of London University. St Mary's chief executive Julian Nettel said the merger would aim to secure the future of both trusts in the new market. The proposal comes after the plug was pulled on the disastrous £1bn Paddington Health Campus scheme in June last year, which would have seen St Mary's merge with the Royal Brompton and Harefield trust. The proposals would not be for a super hospital on one site but an organisational model between the two trusts. Summary by Keep our NHS Public of Health Service Journal 16 February 2006
• Patients: "Give us a voice". The Patients and Public Involvement Forum for University Hospitals of Leicester NHS Trust is calling for a reversal of the decision not to allow it a place on the council to run the General and Glenfield hospitals and Leicester Royal Infirmary, in the event of the trust winning foundation status. The trust had said there would be no place for the forum, despite earlier suggesting that there would be. The trusts foundation status has been put on hold while the government scrutinises details of the £761 million Pathway hospitals improvement project. The forum says that this gives the trust the opportunity to reverse their decision. The forum was supported by two Leicestershire MPs who said that the organisation needed a voice. The forum has written to the Secretary of State, MPs and the joint overview and scrutiny committee, urging them to put pressure on the trust to change its mind. The trust remains unmoved. Summary by Keep our NHS Public of Leicester Mercury 24 February 2006
• Foundation trusts warned about taking investment risks. Foundation Trust regulator Monitor has warned trusts that they must be cautious when investing their money, particularly in non-health care schemes. Monitor said that foundation trusts must report to it about any high-risk transactions they are involved in. Summary by Keep our NHS Public of Public Finance 24 February 2006
• Foundation Trust Network calls for total overhaul. The existing payment by results system should be completely overhauled to allow an independent agency to set the tariff, according to the Foundation Trust Network, after the tariff for 2006-7 was withdrawn by the DoH due to errors. Summary by Keep our NHS Public of  Health Service Journal 2 March 2006
• Foundations lagging on pay reform. Foundation trusts are falling behind the rest of the NHS on moving staff to new working contracts, according to a survey by Unison. Only a third of the 32 organisations had fully assimilated staff on Agenda for Change contracts by the end of February, while the rest had delayed implementation by up to six months. Unison senior national officer for health Mike Jackson said: "Part of the agreement to become foundation trusts was that these organisations would implement Agenda for Change, but it seems that trusts are delaying implementation to offset financial problems." Summary by Keep our NHS Public of  Health Service Journal 17 March 2006
• Flagship foundation £29m in the red. University College London Hospitals foundation trust hit a deficit of £29.4m by the end of December, has breached its licence and could be subject to a Monitor intervention if it fails to improve. It has only avoided such a fate so far by voluntarily calling in consultants KPMG. Elsewhere Moorfields Eye Hospital foundation trust could also face intervention after it became the only trust to be rated red for governance risk. A further 19 foundations were rated amber and in danger of not meeting all national targets. Summary by Keep our NHS Public of  Health Service Journal 17 March 2006
• NHS's £6bn IT programme 'in need of significant changes'. Richard Jeavons, the man charged with implementing the NHS IT programme, has said it needs "a new operating model" and is being "refreshed" in the light of government policy changes since its launch in 2002. The government has moved to introduce a supplier market, bringing in private sector operators, competition, foundation trusts and patient choice and there are "significant changes arising from that". 'Choose and book' should have been in widespread use by last December but the target for full implementation has now moved well into next year. Patricia Hewitt has said that even by August only 1m of the 13m first outpatient appointments made annually will have gone through the system. Sir John Bourn, head of the National Audit Office, said the programme has become "a focus of dissension" within the NHS. Summary by Keep our NHS Public of  Financial Times 21 March 2006
• Fixation on deficits could 'derail' foundation project. The foundation trust programme could be 'derailed' by the government's fixation on NHS deficits, the Foundation Trust Network has warned. A report by the Network highlights several factors contributing to the threat to the foundation trust programme, including the low uplift in this year's tariff for payment by results and 'problems with commitments to private finance initiative projects'. It says the government could fail to reach the minimum target of 65 foundation trusts by next April, and it is unclear where the next phase of applicants will come from. Summary by Keep our NHS Public of  Health Service Journal 6 April 2006
• PbR under the microscope: what the South Yorks boffins found. York University has been running a 'South Yorkshire laboratory', a DoH commissioned study of how payment by results is changing healthcare in South Yorkshire, where all four of the county's acute trusts are foundation hospitals, meaning PbR has been rolled out further than in the rest of the country. The report found that commissioners must ensure that they are getting exactly what they want from their providers, who as foundation trusts now have a very powerful incentive to generate as much income as possible. The report questions whether providers are inducing demand in a system that their commissioning client can currently neither control nor, in many cases, afford. Sheffield PCTs in particular have blamed aggressive foundation trusts for their debt problems. One report interviewee said: "I'm not suggesting at all that the hospitals are gaming on non-elective or elective work: they're maximising as much as they can get away with because everything gets a tariff. Sheffield Teaching Hospitals foundation trust chief executive Andrew Cash.says acute trusts are beginning to stop running certain services because they are not profitable. He warns that the new system is not well suited to emergency non-elective care or to chronic conditions and long-term care pathways. Summary by Keep our NHS Public of  Health Service Journal 6 April 2006
• Concern over Gateshead 'breach'. Gateshead Health foundation trust 'might be in significant breach of its authorisation', according to independent regulator Monitor, which has has 'serious concerns as to the trust's liquidity'. The trust is 'stretching its creditors' and is not 'adhering to best practice' in paying back lenders. Meanwhile, University College London Hospitals foundation trust is failing to operate 'in an effective, efficient and economic way', according to Monitor. The regulator has so far decided against intervention, but the trust has to submit a recovery plan by the end of April that must show the 2006-07 deficit will not exceed £10m, and that it will have broken even and improved its financial risk rating from 1 to 3 on a scale of 1-5 by April 2008. Summary by Keep our NHS Public of  Health Service Journal 20 April 2006
• Forum to be set up for foundation governors. Foundation trust governors are set to establish a national forum to represent their interests. The forum, which is set to go live in September, will be hosted by either the King's Fund or the NHS Confederation and funded through members' subscriptions, with funding from the Department of Health for start-up costs. Summary by Keep our NHS Public of  Health Service Journal 27 April 2006
• Trust blames deficit on PCT. Harrogate and District foundation trust is facing a £9.2m deficit this year and blames Craven, Harrogate and Rural District PCT's plans to cut the amount of work given to the hospital by £7m for 2006-07. The cost-improvement programme will "necessarily impact on the level of capacity available within the trust". Summary by Keep our NHS Public of  Health Service Journal 27 April 2006
•   Overhaul of regulation needed for 'new' NHS to work, warns minister. Lord Warner has said that big changes are needed to the way healthcare is regulated to respond to recent developments that shifted care out of hospitals, turned more hospitals into free-standing foundation trusts and allowed new independent sector providers to enter the NHS market. In an interview with the FT, Warner made clear that ministers plan to press on with a new supplier market in healthcare and are thinking through crucial regulatory changes that will be needed as increasing amounts of care come from organisations no longer run directly by the NHS. He indicated ministers were inclined to keep the regulation of health service quality and finances together, as the Healthcare Commission wants, rather than split them up, as Monitor would prefer. History suggested that if the two were separated "there is a risk that the quality regulator will raise standards to the point of unaffordability". Monitor's argument is that the financial regulator might approve actions taken by providers to keep themselves in business, which a quality regulator - the Healthcare Commission - could then say openly were damaging patient care, meaning there would be no hidden trade-off. But Warner said stronger commissioning by the 10 new SHAs and the new PCTs could deal with competition issues - for example, the risk that a sole provider in an area could come to dictate prices to the service. SHAs and PCTs "will have an interest in keeping a variety of providers where they can, and they should not be entering into contracts with providers who are not meeting the specifications that they require". He said regulation also needed to be extended into primary care. Summary by Keep our NHS Public of  Financial Times 28 April 2006
• Hospitals told to embrace reforms. Health minister Lord Warner has said local hospitals risk becoming "unpopular, unsustainable and probably unsafe" if they do not adapt to the government's NHS reforms. He said hospitals will need to change care is moved out of hospitals, new independent sector providers enter the market, and more hospitals move to foundation trust status. These reforms mean local hospitals have to "face up to the need to reconfigure services". The position of "the most financially challenged hospitals" raised questions "about the way their services are configured" and not just about their financial management. He said "it is down to trusts, boards, clinicians and managers locally to face up to the changes that are needed", which "cannot be driven from the Department of Health in Whitehall". Summary by Keep our NHS Public of  Financial Times 2 May 2006
• The politics column - Allyson Pollock. In the New Statesman's main political column, Allyson Pollock writes: "According to Patricia Hewitt the NHS has had its best year ever. So why is the Royal College of Nursing threatening industrial action over cuts and closures, and why did the annual conference of Unison, traditional Labour supporters, greet the secretary of state with heckling? In her words, "the NHS must modernise or die". So why, from Surrey to Manchester and from Gateshead to Shropshire, are local people banding into hospital action groups and "Keep our NHS public" campaigns in an effort to defend the health service ? The chief targets for cuts are mental health services, palliative care, older people's care and emergency hospital care, yet Hewitt maintains, to general derision, that quality will not be affected… Pay accounts for 60-70 per cent of NHS hospital budgets, but pay awards accounted for less than 30 per cent of the new money and should have been absorbed easily. Nor was greed involved; the increases returned NHS pay to previous levels after years of pay freezes. The hourly rate of the lowest-paid rose initially from £5.16 to £5.67 an hour; medical consultants got increases of 4-5 per cent a year, taking them to averages of between £75,000 and £95,000, while managers - their numbers swollen by the complications of marketisation - got 7.5 per cent more last year. The real reason for the decision to axe in excess of 13,000 clinical staff and 1,000 NHS beds, plus associated services, is market-oriented reforms such as "choose and book", "payment by results" and foundation hospitals. Hospitals and services are required to behave like stand-alone companies, competing with each other and private corporations for income and patients… The government plans to hand over most of the NHS budget to the private sector through "practice-based commissioning". Under this policy, local PCTs will eventually contract with for-profit companies such as the US-owned UnitedHealth Europe to provide GP services… The Prime Minister asserts that the reforms are bearing fruit, and so they are - for "investors" such as the lucky shareholders of Norfolk and Norwich and Bromley PFI hospitals, who received a windfall of more than £500m within months of the new hospitals opening. But the PFI has been less "fruitful" for local people, who have seen a quarter of beds closed and clinical staff and community provision cut. A large part of hospital trust deficits is due to PFI debts, running at £1.5bn a year… And then there are the costs associated with establishing and operating a market - costs the NHS was explicitly designed to avoid: these are for invoicing, marketing, advertising, drawing up hundreds of thousands of contracts, legal disputes with contractors and rival hospitals, and using management consultants… And though NHS hospitals remain responsible for balancing their books, the government has ensured that the only way they can do so is by cuts, closures, the sale of land and buildings - and more privatisation. Some foundation trusts are entering joint ventures with companies such as the Hospital Corporation of America, providing care to private patients in what were previously NHS beds. Others are charging NHS patients for "extra" care: Queen Charlotte's and Chelsea NHS hospital has introduced a fee of £4,000 for one-to-one midwife care - once the NHS standard - and the government is allowing it. The less fortunate hospitals - if that is the right word - are closing services and sacking staff. Is this what the English patient needs or wants ?" Summary by Keep our NHS Public of  New Statesman 2 May 2006
• The need for a recovery regime. It is now more than two and a half years since the health department promised to produce an insolvency regime for foundation trusts. When a foundation trust hits financial trouble - as at least four of the 32 have so far in their two-year existence - Monitor can intervene. It can demand a recovery plan, fire the board or chief executive and impose a turnround team. If all else fails it can dissolve the trust, merging it with another one, or in the last analysis return it to the secretary of state's ownership. But there is nothing in the middle: no insolvency procedure that would allow viable parts of the business to be kept going, and at the same time leave suppliers and lenders certain where they would stand financially. In the US, Chapter 11 procedures provide protection against creditors, offering insolvent hospitals the opportunity to restructure debt and carry on trading. Without similar certainty in England, banks are unlikely to be willing to lend substantial sums on acceptable terms, calling into question the much-vaunted freedoms that foundation trusts are meant to enjoy. Summary by Keep our NHS Public of  Financial Times 3 May 2006
• Trusts Plan Thrown into Disarray. Cuts in mental health services by Stoke-on-Trent's two PCTs have scuppered the bid of North Staffordshire Combined Healthcare trust to become a foundation trust. Financial uncertainties mean the trust failed to be awarded foundation status by Monitor. While against foundation trusts in principle, leaders of Combined Healthcare's 2,500 staff have joined management in condemning the cuts to be imposed by North and South Stoke PCTs. Summary by Keep our NHS Public of  Stoke Sentinel 4 May 2006
• £4m Budget cut for mental health care. Patients in Stoke-on-Trent face being denied some mental health services as the city's primary care trusts plan to slash £4m from their psychiatric services budgets. The figure represents a 10% reduction in funding and has wrecked North Staffordshire Combined Healthcare trust's bid for foundation status. Combined Healthcare is appealing to the PCTs for more time to avoid the cuts and possible redundancies. Summary by Keep our NHS Public of  Stoke Sentinel 4 May 2006
• Mental health trusts get new status. The first three mental health foundation trusts have been launched following authorisation from regulator Monitor. From May 1, Oxleas Foundation Trust, South Essex Partnership Foundation Trust and South Staffordshire Healthcare Foundation Trust joined 32 acute foundations. The authorisation came a month late because of the complications surrounding the payments by results tariff. Summary by Keep our NHS Public of  Public Finance 5 May 2006
• NHS Direct to become foundation trust. NHS Direct said becoming a foundation trust will provide it with incentives to develop new services that could be commissioned by the NHS or private health providers. Foundation status will follow soon after NHS Direct becomes a trust in April 2007. Summary by Keep our NHS Public of  Independent Nurse 8 May 2006
• Hospitals battling to cut costs. The chief executive of the Queen Elizabeth Hospital in Woolwich has said he doubts that it will be in a position to bid for foundation status by the government's deadline of 2008. Chief executive John Pelly said: "It's very difficult to see how, with our financial problems, we can get to the position in the next two years where we can satisfy the financial demands Monitor will make." The hospital is £11m in debt. There is also the extra burden for Queen Elizabeth of the annual £15m costs it must pay to its PFI contractors. Frances Hook, chairman of the Greenwich branch of the national campaign Keep Our NHS Public, said: "The Government rhetoric is foundation status will give communities more control over their hospital. In reality, foundation hospitals will be given unlimited powers to enter into joint ventures with the private sector. The drive for profit will erode patient care and create competition between hospitals." Summary by Keep our NHS Public of  News Shopper 11 May 2006
•   Monitor concern over progress. Of around 170 acute trusts, Monitor says it expects only "around 75" to reach foundation status by 2008, including current foundations, while "up to" 30 of 53 mental health trusts are expected to achieve the same result. However it has just approved five more foundation trusts, bringing the total up to 40. Summary by Keep our NHS Public of  Health Service Journal 31 May 2006
• Foundation hospital pledge 'falling short'. The Prime Minister's promise to have every NHS hospital in a position to assume foundation status by 2008 has been challenged by the foundation trusts watchdog, Monitor. Board minutes of the regulator have revealed warnings from its chairman, William Moyes, that well under 50% of hospitals are set to achieve the status by 2008. The chances of many of those on target to qualify are also in doubt due to deficits, the cost of private finance initiatives and the lack of an adequate payment by results tariff for rural trusts. Summary by Keep our NHS Public of  Guardian 31 May 2006
• NHS foundation trusts not making enough money, regulator warns. Foundation trusts are not making enough money to invest in the renewal of their assets, Monitor has warned. Foundation trusts reduced their net deficit last year by £13m, down to £24m. But Monitor said it was worried that only eight of the 32 recorded a surplus of more than £1m, while seven made losses of that scale or larger. The only sources of investment finance that the foundation trusts had for new buildings and equipment was their retained earnings and borrowing - and few had yet taken the risk of substantial borrowing. Without decent surpluses foundation trusts "will not be able to invest in the new facilities and improved services that patients will expect", Monitor said. Some foundation trusts are having trouble getting paid. The 32 trusts have made provision for £28m of "bad debt", where they fear cash-strapped primary care trusts will not pay them for work carried out. Meanwhile, Bupa has been named as the preferred provider for the first of a new wave of 13 independent treatment centre schemes. Summary by Keep our NHS Public of  Financial Times 6 June 2006
• Business executives help prepare for market-based health reforms. Senior executives from some of Britain's biggest companies are to join the boards of foundation hospitals to help them prepare for a new market-based health service. Tony Blair is hosting a seminar with health managers and representatives from companies including Tesco, Lloyds TSB, GlaxoSmith-Kline, Unilever and Smiths Group, under a scheme to make foundation hospitals with budgets of up to £500m more commercially minded. Other companies interested in lending their expertise include O2, Sainsbury and Anglo-American. The move has come under fire from union leaders who warn that it would alienate Labour voters. Tony Woodley, general secretary of the Transport and General Workers' Union, said the involvement of businesses proved that foundation hospitals were "pathfinders to privatisation". Analysts have noted that the companies involved are not all strong performers in their sectors. One fund manager said: "They may not all be the most highly regarded companies, but they can at least teach about the profit motive and need to face up to competitive pressures." Summary by Keep our NHS Public of  Financial Times 6 June 2006
• NHS must sack staff, business leader says. The NHS must be prepared to dismiss one third of its staff because they are resistant to change, a business leader told Tony Blair at a Number 10 seminar on bringing businessmen into the running of foundation hospitals. Richard Lapthorne, credited with saving Cable & Wireless and British Aerospace after widespread job cuts, suggested the same measures to foundation hospital chiefs. His advice fulfilled the worst fears of the unions, but Blair said that private sector experts could help foundation trusts to make the NHS more businesslike. Lapthorne said the lessons of the free market had to be applied to the NHS. He said that NHS middle managers opposed change because it challenged their power. Asked what should become of those resistant to change, he said: "You fire all of them." Blair told Lapthorne: "I think that is absolutely right ... There is a huge culture change that is going to be necessary here. It has to break the myth that public service and notions of proper business management operate in two separate spheres with contradictory value systems. That is where you can help us. You are right: it is going to be difficult." Summary by Keep our NHS Public of   Times 7 June 2006 [Our experience is that NHS staff loyally implement policies that they know to be misguided and likely to be reversed before they could possibly realise their supposed benefits]
• Union bosses attack 'private-sector NHS involvement'. Union bosses have said a meeting between the Prime Minister and private sector firms to help the health service was not the way for Labour to win back its supporters. Blair met executives from some of the country's top FTSE 100 firms at Downing Street for a business breakfast, including Tesco, Lloyds/ TSB and Smiths Industries. Other firms which have expressed an interest include Unilever, Yell, O2 and Sainsbury's. The Government said it was interested in "importing" private sector expertise into NHS Foundation Trusts. Unison's head of health Karen Jennings said: "The NHS needs people who understand healthcare and how health systems work. Hospitals aren't businesses that can be closed or moved elsewhere and patients aren't products. If you parachute FTSE directors on to the boards of Foundation Trusts those hospitals are in danger of falling hostage to big business." Alex Nunns of campaign group Keep Our NHS Public said: "Bringing the top-brass of supermarkets into the running of foundation hospitals is completely inappropriate. Are these people really best qualified to identify local health needs and match them with services - which after all is what a health service is for - or is this just about helping foundation trusts to grab more income and drop unprofitable activities ? Tesco may be very good at the latter, but the former is what matters to people who use the NHS." Summary by Keep our NHS Public of  24dash.com 7 June 2006
• Trust goes it alone on private bid. A London trust is snubbing bidders under the DoH's independent sector treatment centre scheme in favour of setting up its own deal with the private sector. Bidders hoping for contracts in South West London under the DoH's second wave of ISTCs asked to use Kingston Hospital NHS Trust facilities in their schemes. They wanted to use the Kingston site as either a 'hub' or 'satellite', centre but the trust executive has recommended refusing such requests. In a bid to become a foundation trust, the hospital wants to set up its own private sector partnership. If Kingston's plan is successful it will compete with the DoH's ISTC for elective work. Summary by Keep our NHS Public of  Hospital Doctor 8 June 2006
• Treaty clash between rivals. Friction between regulators Monitor and the Healthcare Commission was growing this week over the former's reluctance to sign up to a concordat designed to reduce the regulatory burden on trusts. Monitor chair Bill Moyes criticised the commission for its persistent attempts to get it to join the concordat which was set up in June 2004. It aims to remove overlap and duplication in inspection, audit and review. Moyes said he was worried that trusts subject to a Monitor intervention would be able to use the concordat to 'fend' it off. Summary by Keep our NHS Public of  Health Service Journal 9 June 2006
• Foundation status hope for trust. Durham and Darlington Acute Hospitals Trust hopes to start becoming a foundation trust by November, despite announcing only in March that it was to axe as many as 300 jobs over the next three years. Summary by Keep our NHS Public of  BBC Online 13 June 2006
• Blair is urged to support foundation trust ventures. Foundation trusts should be given the political backing for widespread joint ventures, mergers, and 'acquisitions' with other trusts, the Foundation Trust Network has urged the prime minister. FTN director Sue Slipman said that where foundation trusts had reached "a critical mass" in a health economy they should be free to "team up" with "other trusts that are failing or do not yet have the opportunity to become autonomous bodies" to drive cultural change. She said in areas with the biggest problems, you would need "a bigger, stronger foundation presence [so that] you might look at reconfiguration of services and assets." Summary by Keep our NHS Public of  Health Service Journal 15 June 2006
• The chairwoman of an NHS trust is set to attack Government health reforms which, she claims, threaten the future of the service. Debbie Abrahams, chair of Rochdale Primary Care trust, will tell a protest rally in Manchester she is speaking out before the health service reaches "the point of no return". She will say: "I believe passionately in the NHS. For me it is not just about how we organise and provide health care, it reflects and represents the values of our society." And she will continue: "During my period as chair of Rochdale PCT, I have seen a steady stream of national policies introduced - Foundation Trusts, Choice, Independent Treatment Centres and now Commissioning a Patient led NHS - which threaten these values and the future of a NHS that is equitable and free at the point of need." Press Association Saturday June 24, 2006 10:03 AM
• Patients turned away over dispute. A foundation hospital is turning patients away because of a dispute with the primary care trust over money. The Royal