Monitor and TDA could merge, Burnham suggests

Speaking at a press conference this afternoon, Mr Burnham said it “made sense” to have a single regulatory regime for both FTs and non-FTs, but added that he had not made a “firm decision” on whether to merge the two organisations.

His comments followed the publication this morning of Labour’s 10 year plan for the NHS, which promised to consult on “how to release even larger savings” from the new organisations created by the coalition government’s health reorganisation, including “by addressing potential duplication of responsibilities and further reducing bureaucracy”.

Under the government’s health reforms, Monitor was given a wider set of regulatory roles, while retaining specific regulatory responsibilities for FTs. The TDA, while not a statutory regulator, has oversight and performance management responsibilities for non-FTs.

In response to a question from HSJ this afternoon, Mr Burnham said: “I have not made a firm decision [about merging Monitor and the TDA] if I am being honest with you, but it makes sense to look at all trusts the same way rather than having an FT approach and then a non-FT approach. It makes sense to look at all health economies together.”

He added: “Health economies are a mixture, mostly, of some FTs and some non-FTs working in community or mental health.

“I can’t justify an approach anymore which is all about the individual viability of institutions because if you are trying to secure one [organisation] as an FT, you might hoover out resources from everyone around it and destabilise other services.

“So that’s a big change to the way we’re going to ask Monitor to work.”

Mr Burnham has made clear that he intends to retain Monitor, albeit with a considerably different remit.

As previously anticipated by HSJ, Labour’s 10 year plan proposes to change Monitor’s role from inspecting the financial viability of individual organisations to assessing the viability of whole health economies.

Mr Burnham has also said he would charge Monitor with a duty to ensure integration rather than competition.

He explained today that the regulator would “advise annually on the financial sustainability of each health economy”. This, he said, “would [give] a pretty clear indication if people are on the right path or the wrong pass” in terms of their “journey” towards the ultimate end goal of a pooled health and social care budget.