NHS chief challenges Andrew Lansley’s foundation hospitals plan

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Sir David Nicholson says health minister is wrong to block failing foundation hospitals from returning to direct NHS control The government’s health reforms ran into further trouble on Tuesday when the chief executive of the NHS publicly challenged a key proposal. As peers prepare to table a series of amendments to the health and social care bill, Sir David Nicholson said the government was wrong to block failing foundation hospitals from returning to direct NHS control. Andrew Lansley, the health secretary, wants to repeal a provision in the 2006 National Health Service Act which allows for the “de-authorisation” of failing foundation trusts, triggering their return to NHS control. The change is designed to strengthen foundation trusts – a central element of the government’s plans to decentralise power in the NHS – which will eventually take over the running of all hospitals in England. In evidence to the public inquiry into failings at the Mid-Staffordshire NHS Trust, Nicholson called on the government to retain the renationalisation of a failing trust in its “armoury”. Nicholson is understood to have voiced, in private, reservations about the Lansley plan, which was introduced as an amendments to the bill after the government’s “listening exercise” on the NHS reforms. Nicholson told the inquiry: “I do think that the opportunity in a sense to renationalise a foundation trust should be part of the armoury of any government in these circumstances. It’s not one shared, I have to say, by the government. But it’s something that I believe to be the case.” Asked by Tom Kark QC, counsel to the inquiry, whether his proposal went against the government’s central policy, Nicholson hesitated, then said: “They want all organisations to be foundation trusts, but I believe that from time to time it may be necessary for the state to take the direct management of an organisation.” Labour will lambast the health reforms at the party’s conference in Liverpool on Wednesday. Liz Kendall, the shadow health minister, said: “For David Nicholson to so directly and publicly contradict Andrew Lansley is a damning indictment of the Tories’ NHS proposals. Labour tabled amendments to the health bill to ensure foundation trusts can revert to NHS trust status in the event they fail, in order to protect patient care. Lansley must now listen and stop his reckless and risky NHS plans.” In a note on the bill this month, the government said of Lansley’s plan: “As a result of the amendment, the regime would be more independent and transparent, reducing unnecessary costs and delays, with additional safeguards for patients and taxpayers.” Nicholson told the inquiry: “The arrangements that we’re putting into place when the strategic health authorities are abolished at the end of March 2013 are that we will have to set up something that will be called the National Health Service Trust Development Authority, which all those organisations that are not foundation trusts by that date will be accountable to that body. And that body then will be responsible for taking those organisations through to foundation trust status.” The Mid Staffordshire inquiry, which is being chaired by Robert Francis QC, is to return to the matter on Wednesday. Francis is chairing his second inquiry to discover why as many as 1,200 patients died of preventable causes at Stafford hospital between 2005 and 2008. The intervention by Nicholson comes at a sensitive time for Lansley. Peers are due to debate the bill on 11 October. Ministers are saying they will have to accept further amendments to the bill in the House of Lords because a hardcore group of rebel peers, led by the veteran Liberal Democrat Lady Willliams, are determined to challenge the government. Labour will condemn the bill at its conference in Liverpool. John Healey, the shadow health secretary, has warned that David Cameron faces a “lethal” threat as increasing numbers of voters decide he is threatening the security of the NHS. Health policy Health NHS Public services policy Nicholas Watt guardian.co.uk

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