In England, do ministers and civil servants really understand NHS governance? – unlikely!

Health is the most politicised of all government services. At the Department of Health, command and control is the order of the day. No surprise, then, to find that both ministers and David Nicholson, Chief Executive of the NHS at the Department of Health, appear to be attempting to directly control NHS foundation trusts in contravention of the governance arrangements under which they operate.

This issue has arisen because of serious governance failings at Maidstone and Tunbridge Wells, which resulted in some 90 patients dying from hospital acquired infections. As a consequence, the Department of Health issued instructions to all NHS hospitals, including ‘independent’ foundation trusts, on measures they should be taking to improve hospital hygiene. David Nicholson has defended the Department’s actions saying that “…..every NHS board has – as part of the NHS family – a very real duty on behalf of their patients to learn lessons from what happened at Maidstone and Tunbridge Wells to ensure it never happens again.”

Bill Moyes, Chairman of Monitor, the regulator of NHS foundation trusts, has written to David Nicholson expressing his concerns about the Department issuing instructions to foundation trust hospitals as if they were still under the Department’s direct management control. Under the new governance regime, foundation trusts are accountable to local members (owners) and are independent of the Department of Health and government.

The Guardian newspaper has published an article on the affair, which can be viewed here.

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