Authorising aspirant foundation trusts by 2014 will be an “almost impossible challenge” if the Department of Health decides to “backload” applications, Monitor’s chair has warned.
David Bennett raised concern that Monitor could be swamped with FT applications by the government in the run-up to the 2014 target when speaking to the health committee this morning as part of an ongoing inquiry into regulatory bodies.
He said: “One of the things we’re very concerned about is they [FT applications] will all finish up being backloaded which presents us with an almost impossible challenge.”
Mr Bennett said he had made it “very clear” to the department that there was need for each trust to be given a “realistic” application date. This should avoid leaving too many applications to the last minute but should also take into account the fact that applications would inevitably not be spread perfectly across the remaining time period.
“And in any case, if we’re not aware of a likely spike towards the end we won’t be able to plan for it,” he said. “I’m encouraging them to bring forward as many as possible but also to be realistic.”
While bill amendments have added some flexibility to the April 2014 foundation trust deadline, the DH has said it expects the majority of trusts to make it by that date.
There are 137 foundation trusts and 90 awaiting authorisation. Of these, 13 have either postponed their application or had it deferred by Monitor this year.
Mr Bennett said he was “absolutely clear” that there would be no lowering of the foundation trust bar. He also said he was prepared to tell the DH if the deadline turned out to be “inappropriate”.
Aspirant FTs faced different types of challenges, he said. One concerned managerial challenges, where trusts “just don’t have good enough leadership teams”. Others faced legacy debts or expensive private finance initiatives, the latter of which are being scrutinised by the DH.
“I understand their emerging conclusion is that there aren’t that many trusts where the PFI is the fundamental problem,” Mr Bennett said.
He also argued it was certain that many trusts – including those with foundation status - needed to improve productivity, which would have knock-on effects on the configuration of services.
Asked whether this was happening quickly enough to save £20bn by 2014-15, Mr Bennett said a “very consistent concern” among FT chairs and chief executives was that they would find it difficult to make more significant productivity changes at a fast enough pace.
Regarding commissioners’ role in this regard, he said: “This is a nettle they need to grasp more firmly.”