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Reconciling Equity and Choice? By John Mohan A Catalyst Working Paper. Provisions for the creation of "NHS Foundation Trusts" in the Health and Social Care Bill 2003 have polarised the Parliamentary Labour Party. This paper, by a leading expert on the history and geography of health care restructuring in the UK argues that the reform has the potential to undermine an efficient, integrated and equitable NHS, free at the point of use and planned according to social need. Professor Mohan argues that despite some concessions to critics and the Treasury-DOH compromise over borrowing powers, the legislation may result in significant distortions and inequities in the allocation of investment, revenues and trained staff; that superficial structures of local accountability and mutualism will do little to restrain the powerful dynamics of competition and commercialisation that will be unleashed; and that the new regulatory regime may in fact have the effect of entrenching the role of private sector provision in some areas and increasing the scope for user charges. "UNISON shares many of the fears raised in this insightful paper
about Foundation Hospitals. I have no doubt that Foundation Trusts will
lead to increased privatisation, higher costs and damaging competition
in the NHS." John Mohan is Professor of Geography at the University of Portsmouth. He has published widely in academic and professional journals on historical and contemporary geographies of health and health care, and is the author of Planning, Markets and Hospitals, 2002.
"LGA joins fight against Foundation" - Public Finance, 28 March 2003 |
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