Health secretary Andy Burnham has questioned the ability of foundation trust governors to hold boards to account in an exclusive interview with HSJ.

He said the foundation trust vision had been one of “powerful governors that could hold FT managers to account, but I think there is more we can do on that”.

The model was we traded some national accountability for stronger local accountability. I want to satisfy myself we really are getting that

The Department of Health could announce proposals to “strengthen” foundation trust accountability within weeks, Mr Burnham said.

When HSJ put it to him that foundation membership and local accountability had been something of a “damp squib”, the health secretary said: “You wouldn’t be wrong if you said that.

“The model was we traded some national accountability for stronger local accountability. I want to satisfy myself we really are getting that,” he said.

“There is more thinking to be done about accountability at the local level and if FTs are really following the aim of the policy set out in 2003-04 for real local accountability and the role of boards.”

Recent research found the average turnout of foundation trust members in governors elections fell from 48 per cent in 2004 to just 27 per cent in 2009.

He was speaking to HSJ after he launched the Labour Party’s “vote NHS” campaign, in which the party focused on its pledge to turn waiting time targets into “patient entitlements” and “guarantees”.

Prime minster Gordon Brown has also announced a new “guarantee” for cancer test results within a week of GP referral, to be implemented by the end of the next Parliament.

Mr Burnham said the new promise had been “carefully chosen” as it fitted with the attempt to shift activity out of hospitals because it would require more tests to be done in GP practices. He acknowledged it would have “implications” for hospitals, but said the government was prepared to “make difficult decisions” to support the shift, despite the imminent election.

“We are looking to make [that] challenging and important argument. We need to have a better public debate,” he said.

But asked if he would dissuade local Labour party activists and candidates from opposing reconfigurations, he said: “I cannot dictate to my colleagues at a local level. They have a job to speak up for their constituents which is different from the job of a health minister.”

Patients shortchanged in local trade-off