Question: NHS - the case continues

The case for control. The introduction of Foundation Trusts has not been without its critics. Some pointed out that they go against the NHS principles. Others doubt whether the Foundation members will be able to control hospital management, which is heavily influenced by powerful medical professionals with a tradition of autonomy and resistance to outside interference with their professional judgements. A further concern is that Foundation Trusts will quickly copy the US and come to see some conditions as more profitable (or less costly), and concentrate on those at the expense of others.

A 2007 World Health Organisation report found that despite US expenditure being almost double that of the UK, the outcomes were no better. A study undertaken by the King's Fund in Homerton University Hospital NHS Foundation Trust found the governors disappointed and disillusioned. One governor said: I regret to say that I wouldn't be able to pinpoint a particular point or issue that I have been able to achieve by my being a governor. Another report found that it is too easy to invite members to sit on sub-committees where they quickly become bogged down in the minutiae of operational planning, while the main decisions are taken elsewhere.

Case questions:

· Why do you think it would be difficult to exercise effective control in the role of hospital governor?

· Why do you think professions such as doctors resist managerial control?