Foundation trusts fear ministers may undercut Monitor role

MPs at a Commons health select committee hearing last week heard ministers may legislate so that the government can direct foundations to act, and de-authorise them.

Monitor refused to respond directly to the comments until the government’s intentions are made clearer.

But foundation trust network director Sue Slipman warned: “It would be unwise for the government to undermine the independent regulator, Monitor, which was given the power to authorise foundation trusts.

“There must be independent, evidence based judgement on issues of authorisation and de-authorisation.”

Mid Staffordshire foundation trust was authorised shortly after the Healthcare Commission began looking at its standards, and after higher than expected mortality rates were identified.

Asked whether the government should be able to remove foundation status, then health minister Ben Bradshaw told the hearing: “That is something that certainly I think will be part of the deliberations that are under way at the department at the highest level to decide what legislation may be necessary to address some of the concerns that have arisen out of this case.”

He also said the government was considering action where foundations’ boards do not meet in public - another issue raised in relation to Mid Staffordshire. He said the government was considering “whether we may need to take further powers”.

The Department of Health later said it was considering “legislative or other changes”.

The Health Bill before Parliament includes provision for foundations to be de-authorised under the government’s plans for unsustainable providers, but this would be triggered by Monitor.

Following the Healthcare Commission’s report on Mid Staffordshire, NHS chief executive David Nicholson highlighted guidance that says boards should meet in public. An HSJ straw poll in April suggested less than a quarter of foundations did so.

Ms Slipman said: “Forcing foundation trusts to hold board meetings in public may not offer the solution the government is seeking.”