White paper plans for moving trusts to foundation status are “not very sophisticated”, the NHS Confederation has warned.

A consultation paper published this week says “difficult questions remain” about how government plans to move all trusts to foundation status by 2014 will be achieved. And it cautions new powers proposed for Monitor, which will become the new economic reglator, might be disportionate

The confederation’s paper, Liberating the NHS? Analysis and questions on the white paper, says it is unclear whether the regime for bringing all trusts to foundation status, through takeovers and insolvency, will succeed.

It states: “In moving all trusts to FT status there is a concern that there has not been a very sophisticated approach to understanding the obstacles that some organisations face.”

It asks: “If takeovers and the special administration and insolvency regime are not sufficient to ensure that all NHS trusts achieve FT status, what are the solutions for non-FTs?”

The paper also asks whether the powers proposed for Monitor, such as the ability to set higher prices for individual providers, and having responsibility both for ensuring service continuity and regulating competition, may be “out of proportion with other parts of the system”.

It asks: “Are there sufficient safeguards to ensure that the regulator does not have conflicts of interest between its different roles and in balancing the interests of other parts of the system?”

It is also “not clear” if there is a convincing reason for the exclusion of maternity and paediatrics from the remit of consortia, the document says. Also unclear, it says, is whether the NHS commissioning board will have sufficient powers over consortia and how it will be held to account by Parliament.

The confederation is asking members to respond by 24 September, in order to feed into its full response to the white paper consultation.