One of the problems of the foundation hospitals program is the way the criteria are applied. Foundation Hospitals are based on a star rating system. Once they get three stars they get Foundation status. They get these stars by government targets. These targets are based on waiting lists, they try to see as many new patients in one day. But there are no targets for follow up appointments. In an eye hospital, it was found that most existing patients were being neglected, as doctors were forced to give priority to new cases over existing patients that were already being treated. As a result of this policy in this hospital 25 people who were receiving treatment lost their sight.

Another problem is what happens after a hospital gains this status. More precisely, what happens in such hospital in relation to other hospitals that don't gain that status. Foundation hospitals will have complete freedom to contract services with the private sector. They also have freedom to contract medic staff at higher prices than standard. They are also free to use their financial resources to buy equipment without consulting with any local or national authority. The logical result of this will be, that the best doctors in the country will concentrate in these hospitals. Staff in the hospitals that don't have foundation status will want to move to these hospitals, rather than improve those they are working on, unless they get that status. Before, each hospital had to give up an amount of money called 'surplus' to the National Treasury. This body would then re-distribute this money according to each hospital's needs. Now this will change. With the foundation hospitals' autonomy, richer hospitals will keep that surplus, will improve their equipments and will employ the best (and most expensive) staff. And poorer hospitals will keep their poor status because they can't afford new equipment or proper training for its staff.


One reason the Government is giving for these changes is that the control of hospitals needs to get back to the community, rather than the central government as is the case now. But the fact is, these hospitals will be dealing their services with private companies. These companies are more often than not translational corporations. With that central control, hospitals would have the backing of the UK government when dealing with those companies. With foundation hospitals, when private interests of a company clash with the public interests of a community, the local councils will be left alone with their hospitals.


Unison, the nurses' main union, is strongly against these foundation hospitals and believe they threaten the very principles of the National Health service.