FOUNDATION hospitals have been greeted by a wave of apathy from the public and even their own staff, an expert declares today.

Professor Rudolf Klein of the London School of Economics says that government plans to involve local people in the running of foundation hospitals have so far largely failed.

The “social ownership” of hospitals, and their governance by boards elected by the public and by staff, was introduced to appease Labour MPs opposed to the idea of setting the foundation hospitals free from Whitehall control.

The rhetoric assumed that “local people do indeed want to be involved in running the NHS”, Professor Klein writes in an editorial in the British Medical Journal. The reality has been that for many of the aspiring trusts “the challenge has been to overcome apathy”.

He cites the case of Bradford Teaching Hospitals NHS Trust, which in evidence to the House of Commons said that its aim was to achieve a “membership” of 10 per cent of the local population.

“That seems a reasonable, if modest, aim,” he says. But when the ballot papers were sent out in March there were just 1,143 members, and only half bothered to return them. “So 541 local people (well under 1 per cent of the population) chose the 17 governors.”

A similar lack of interest was demonstrated by other trusts that have achieved foundation status, with only specialist hospitals such as Moorfields Eye Hospital bucking the trend, he says.

While apathy among public and patients was predictable, the lack of interest by staff was more surprising. In Bradford Teaching Hospitals NHS Trust, just 263 out of a total 3,600 staff voted to elect four governors.

“The public and staff figures are appalling,” Professor Klein writes. “They might reflect cynicism about the role of the governing board — why bother if the boards are going to be window-dressing? But if the boards do indeed turn out to be largely decorative, as well as unrepresentative, then what becomes of the rhetoric of community control and accountability?” If that is just “pasteboard stuff” it will be more difficult for foundation trusts to escape Whitehall control, he said.

The professor is also critical of the fact that neither the Department of Health nor the independent regulator appointed under the legislation has set any rules for a minimum level of participation in the elections. “The result of the elections in the first ten foundation trusts suggests that either there are no such standards or that they are abysmally lax.”

Bradford Hospitals declined to make any comment about its elections. managers at the hospital had seen the BMJ editorial but after discussions hed decided to say nothing, a spokeswoman said.

The office of the Independent Regulator of NHS Foundation Trusts was more forthcoming. A spokesman said that “in our view, the membership numbers and turnout were good”.

He pointed out that trusts could recruit members only in late January, and ballot papers had to go out in late February. “They didn’t have that long” he said.

Some trusts had done much better than Professor Klein implied, he added. At Moorfields, for example, there had been 50 applicants among patients for three places on the board of governors.

The regulator, William Moyes, would be watching closely to ensure that trusts do meet their obligation under the Act to seek “representative membership”, the spokesman said.

There was no plan to set a minimum level of participation, but he added: “We expect that some foundation trusts will push it hard and encourage others to copy them. We also expect that local people will be encouraged by experience and will come forward in numbers to become members of their trusts.”

Tim Yeo, the Shadow Secretary for Health and Education, said: “When the governance arrangements were debated in Parliament, we warned the Government that their plans were burdensome and unworkable. Unfortunately, our fears have been realised.

“The next Conservative Government will scrap these arrangements and replace them with a more streamlined and efficient structure.”

Explore Health News

• Swine flu

Times Recommends

• Iran arrests relatives of opposition leaders
• Banksy rival has final word in art feud
• Electrician travels 175 miles to change bulb