Every NHS Trust in England is now legally obliged to either seek Foundation Trust status or merge with another NHS Trust by 2014. This is part of the regulations to emerge from private consultancy firm McKinsey during the drafting of the Tory Health Bill.
The problem is that 50% of NHS Trusts are failing in their application for Foundation Trust status. This is causing them as a secondary option to seek a merger. A merger, if achieved, is by no means a disaster because at least it gives the trust a chance of remain in public control. So Trafford, Northumbria, St Hellier and Cumbria are all seeking a merger with a more financially healthy NHS Trust close by.
Even if mergers are achieved, however, very often the larger Trust in the merger seeks to offload the less financially viable parts of the supposedly failing trust. For example, Trafford A & E is at severe risk of closure. It is just one of a long list of places under threat that I could bore you with. But there are other problems besides.
Even by joining another Trust to achieve Foundation Trust status, the NHS Trusts enter into a precarious standalone existence where they are expected to balance budgets year on year. These prescribed budgets are subject to annual change (often reductions) and any improvements in infrastructure must be met out of the budget. This is the reason a very many Foundation Trusts have struggled and had to be bailed out already to the tune of hundreds of millions of pounds. The government are in the midst of £20,000,000,000 cuts in our NHS, and the same figure will be applied again once those rounds of cuts have been achieved.
In addition, the government are reviewing Public Borrowing Controls. They have placed McKinsey once more in charge of deciding if NHS Foundation Trusts should be allowed to borrow less as a % of their budget. Currently the limit is 40% but a further reduction would enshrine infrastructural stagnation for NHS Hospitals and mean that all new innovations are likely to come from private investors. A NHS Trust's ability to compete for a host of NHS contracts would be severely weakened. Even more dangerously, if the new NHS Foundation Trusts find themselves unable to stick to the new tight budgetary framework, then they would be legally open to being placed into administration, declared insolvent, carved up and handed out to private investors.
If, as is likely, some NHS Trusts fail to achieve Foundation Trust status & fail to achieve a merger with a NHS Trust locally, then they will be deemed financially insolvent or quality compromised and could (most likely would) be taken into central control pending a sell off to private investors.
On top of all of the financial risks I have just outlined there are also new developments in the expectations of standards that are sure to place hospitals under threat of takeover. Cameron yesterday boasted that his new patient surveys would be used to name and shame failing hospitals. Not to mention that previous NHS Patient Services delivered the highest satisfaction ratings in the NHS's history, Cameron is designing new criteria and formatted questionnaires that he will use to hold individual hospitals to account. 'Failing' hospitals will be taken over, and sold off.
So you can see that NHS Trusts, Foundation Trusts and Hospitals are now under a much greater risk of private takeover than ever before. The government have the means to tighten the budgetary controls and raise the care standards/expectations and then pounce accordingly. In short, the most successful, profitable, and hospital with the highest standard care could be at risk of take over if the government tighten the budget or raise the bar in terms of service expectations. We now live in an NHS world governed by annually fluctuating whims of Tory health bosses who have only one goal in mind. to paint our NHS as failing so that private profiteers can ride in on white horses and save our ailing public health system by privatising in. There is not a single Trust in England, no matter how financially healthy and well performing it is, that could not be painted as failing with a manipulation of their budget or quality surveys.