Drive for hospital freedom challenged

The creation of semi-independent foundation hospitals was championed by Labour and is also being backed by the coalition, although plans to force all hospitals to move into the sector have been dropped.

But work by York University’s Centre for Health Economics suggests that, although foundation hospitals generally perform better against some key financial and other indicators including clinical quality, patient safety and staff satisfaction, the differences are not due to their autonomous status, but instead were long-standing and existed prior to the reforms.

Tracking performance over the last seven years, the results show the performance of foundation trusts and other NHS trusts has tended to converge with any original differences diminishing.

Centre director Professor Maria Goddard said: “Our research basically shows that the policy of greater autonomy seems to have made no difference.

“Some hospitals were better than others to begin with and over time they have all converged and there is no longer any differential performance apparent.”

Foundation trusts were introduced in 2004 and remain a key component of the Government’s plans to free the NHS from Whitehall control.

Researchers say the findings could have wider implications for the Big Society which envisages the creation and expansion of co-operatives, mutuals and social enterprises in running public services.

Prof Goddard said: “Reducing the role of state involvement in public sector services is part of a broader strategy and may well bring wider benefits to communities, but it is not a costless activity.

“This may have implications for similar initiatives in the public sector which involve changing the governance and regulatory structure of organisations in order to impact on performance.”