'Try and get your people to disassociate the message from the messenger'

Q: I run a department in a medium-sized trust that has set its sights on foundation status in the next year or two. This will involve an enormous amount of work, but the attitudes of some of my staff are relentlessly negative about the whole process. They have all been around for some years, know the department inside out and are good at their work, but none of them see foundation status as something they can believe in. Despite having witnessed many changes in the NHS, they view this as a step too far. As such they are reluctant to go the extra mile to work towards it. They are going through the motions and I fear this is beginning to affect the morale of the whole department, but I am reluctant to lose their hard-earned expertise. Any advice?

A: Let's start from the fact that they are good at their work. That is an important beginning. I assume they know that you think they are good at what they do? If not tell them without delay.

The problem with foundation status, plurality, payment by results and choice, is that the government often manages to make it sound like privatisation. It's not, but that's how it sounds because many people in the public sector distrust ministers' motivation and believe the government is besotted with the private sector. There is some truth in this but it's still not privatisation.

Try and get your people to disassociate the message from the messenger and to look at foundation status on its merits. There is a very strong case for it.

Foundation hospitals take us back to boards of governors of teaching hospitals and voluntary hospitals before that. They have real autonomy and real freedoms. The governance arrangements offer the best ever opportunity to involve the public, patients and staff. The care and treatment is still NHS care if it is funded, inspected and regulated by the NHS and provided in accordance with NHS values and standards. What is wrong with that? Distancing the hospital from the strategic health authority is a very good thing. The challenge and rigour provided by Monitor is also very welcome.

Talk it through and see if you can get them to see this as an opportunity for their hospital to take control of its destiny with them as partners and within the framework of the new NHS.

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