Published: 17/03/2005, Volume II5, No. 5947 Page 27

Am I that weird that I am the only man who finds it difficult, at first glance, to take anything called foundations or Monitor seriously?

The pinnacle of my achievement while at primary school was to be made pudding monitor. This entitled me to wear a yellow sash and to transfer the trough of dessert kindly provided by Manchester Corporation, freshly dredged from the River Irwell that very day, to a table full of small boys (me being a very large boy, by dint of securing the semolina distribution franchise).

There I would strike them repeatedly over the head with a large serving spoon until they assumed a reverential posture of quiet engorgement.

And am I the only man of a certain age for whom the word foundation does not immediately produce an image of 21st century organisational effectiveness?

As I remember, foundations used to be the ancestor of what today graces the windows of Ann Summers.

On my first, and thankfully last, blind date I recollect a young woman my mother would have called 'bonny' who turned out not just to be corseted but positively vulcanised. How she got into the damn thing was beyond me. As was getting her out of it. 'Retired hurt' would be entered on the scorecard of that particular innings.

So monitors and foundations: images of malnourished childhood and adolescent fumbling, but do they deserve a place in my monthly ramblings on mental health?

Well they do if only because, after the inevitable outcome of May 5, we are all going to end up monitored in our foundations (That is those of us who are not being Gershoned to death in strategic health authorities and primary care trusts).

But I happen to believe (here we enter career-rescuing mode) that not only do foundation trusts work for mental health, but they also work better than for any other form of NHS provision.

The simple fact is that the governance arrangements could not be better designed for mental health, with our long-standing emphasis on user and carer involvement.

Putting real power into the hands of the consumer and getting them to establish effective partnerships with nurses and therapists is what we have been trying to do for decades.

We are streets ahead of the acute sector in this, and It is the natural next step in organisational reform.

What about payment by results?

Mental health services will not see healthcare resource group-based 'currencies' before 2008-09. Noone has ever done it reliably for mental health anywhere else in the world and it is going to take a lot of hard work for us to get it right in the NHS. Not that we will not - it is the right way to go.

So we have a more appropriate involvement base to form our memberships and boards of governors, and we have less volatility because of the nature of the business and the stable blockcontract-like currency that will be used in the early years.

We also have one other advantage over acute services - large property portfolios. The average mental health trust has many sites at its disposal. And believe me, that is exactly what many of them need doing to them.

Physical assets get you leverage and leverage gets you commercial partners and cash, and that gets you investment in a more modern service base.

Jeremy Taylor is chief executive of Nottinghamshire Healthcare trust, one of the country's largest providers of mental health services.