With the axe falling on jobs and wards closing, health bosses at Lewisham and Queen Elizabeth hospitals already have a lot on their plates. But as they battle to make savings, yet more challenges are rearing their head. CHRIS JOHNSON reports.

BY 2008 the Department of Health wants all acute hospitals in England to be in a position to apply for foundation status.

An independent group called Monitor is responsible for granting hospitals the status and requires a strict set of criteria to be fulfilled by the hospital before it can qualify.

A hospital needs to have two or three stars and be "financially robust" with evidence of a "clear financial plan" in place.

Here the challenge arises for Lewisham and Greenwich's acute hospitals.

Lewisham Hospital, Lewisham High Street, has one star and needs to clear debts of £8m this financial year.

While Queen Elizabeth, Stadium Road, Woolwich, is in a more precarious position with no stars and £11m debts to clear over the same period.

There is also the extra burden for Queen Elizabeth of the annual £15m costs it must pay into the Private Finance Initiative scheme which funded the building of the hospital.

Neither hospital is in a position to apply for foundation trust status even though two years ago Lewisham was poised to apply, but fell to one star last year making the move impossible.

Lewisham Hospital chief executive Claire Perry said: "The big challenge for us is getting into financial balance by 2008 so we can apply for foundation status."

She admits it will be "tough", but says the hospital is on target to achieve this goal.

Chief executive of Queen Elizabeth's John Pelly said: "It's very difficult to see how, with our financial problems, we can get to the position in the next two years where we can satisfy the financial demands Monitor will make."

William Bruce, of the Queen Elizabeth Patient and Public Involvement Forum, said: "With the Queen Elizabeth's current financial crisis it will be impossible for it to fulfil the requirements to become a foundation trust.

"The whole of the south east London health economy is in dire jeopardy and a change to foundation status will cost hundreds of thousands of pounds."

He says it would be better to spend the money on patient care, rather than restructuring.

His views were echoed by Frances Hook, chairman of the Greenwich branch of the national campaign Keep Our NHS, who says the trend towards foundation trusts is evidence of the NHS becoming a corporate machine.

She said: "The Government rhetoric is foundation status will give communities more control over their hospital.

"In reality, foundation hospitals will be given unlimited powers to enter into joint ventures with the private sector.

"The drive for profit will erode patient care and create competition between hospitals."

The south east London Strategic Health Authority (SHA) and Monitor are currently reviewing both the hospitals as part of a 10-week diagnostic process which has now been rolled out nationally.

The aim of the review, which will come to an end in June, is for the hospitals to work with the SHA to determine what needs to be done so the trust can achieve foundation status by 2008.

Foundation trusts

  • FOUNDATION Trusts will still be funded by the Government but will take control of its own spending, services and procurement of private services.
  • It would involve forming a members' council made up of volunteers from the community and a "star chamber" of up to 30 people, which would include representatives from the council, voluntary organisations and members of the public.