Foundation trust mergers threaten local accountability

Via TheyWorkForYou, my recent question on NHS Foundation Trust mergers:

Steven Baker (Wycombe, Conservative)

To ask the Secretary of State for Health whether he has powers to refuse the merger of NHS foundation trusts covering two adjacent counties.

Under the National Health Service Act 2006, the Secretary of State for Health does not have powers to stop two NHS foundation trusts merging. This position would remain unchanged following Royal Assent of the Health and Social Care Bill. The Bill will enable foundation trusts to make their own decisions about organisational change including mergers, subject to strengthened accountability arrangements that require governors to approve decisions.

Foundation trusts will continue to be under a duty of public involvement on matters involving the planning of, and changes to, service provision. Before a merger between two foundation trusts could proceed, the trusts would also need to satisfy NHS commissioners and Monitor of the impact on the continuity of essential services to NHS patients. It could also be reviewed by the Office of Fair Trading whose role is to protect consumers and, in this case, patients’ interests. In all cases, the Care Quality Commission would continue to safeguard appropriate standards of quality and safety.

If foundation trusts are to be locally accountable, then surely they must be small enough for that local accountability to have meaning. Trusts ought not to merge to form larger and even less accountable organisations. It’s something I will watch out for.

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