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@sallygainsbury 1/8 The wording of the capital power proposal in today’s document has followed a long and detailed debate between @NHSProviders and NHSE/I. I wouldn’t describe it as “removing the cornerstone of FTs hospital by hospital”. Detailed explanation of why follows.....
@sallygainsbury @NHSProviders 2/8 You’re right to identify that use of an NHSE/I power to set FT capital limits cuts across accountability of an FT Board. That’s why we oppose it, in principle, but have worked hard to ensure the power is tightly constrained given NHSE/I were determined to take such a power.
@sallygainsbury @NHSProviders 3/8 We have secured 7 constraints. First, it will be specified on the face of the Bill that it is a narrow reserve power only. Second, each use of power can only apply to an individual FT, making it more difficult and complicated to apply the power to a list of multiple trusts...
@sallygainsbury @NHSProviders 4/8 Third, the power can only be used in a single financial year, not multiple years. Fourth, each time NHSE/I use the power, they have to explain why they are using it. Fifth, they have to explain, on each occasion, what steps they have taken to avoid use of the power.....
@sallygainsbury @NHSProviders 5/8 Sixth, because use of the power cuts across an FT board’s accountability, each time NHSE/I use the power, they have to set out the FT’s response. This will enable the FT to set out consequences of use of the power, acting as a major disincentive to its inappropriate use.....
@sallygainsbury @NHSProviders 6/8 Seventh, all of this has to be done transparently and formally published so everyone can see what is going on. We believe this should be done in Parliament as FTs are responsible to Parliament, not DHSC, but we need to wait to see how the Bill is drafted....
@sallygainsbury @NHSProviders 7/8 That’s why the individual single FT by FT use of the power is so important - it’s a key constraint on widespread, general, inappropriate use of the power. This is, I think, the opposite of what your tweet seemed to be arguing.......
@sallygainsbury @NHSProviders 8/8 We would have preferred NHSE/I to drop this power, as they did with power to direct mergers and acquisitions. But given they were determined to proceed, this seems a reasonable set of constraints to have secured. We obviously need to ensure follow through in the actual Bill.
