Limits on Monitor should not threaten foundation trusts

As HSJ reveals this week, the department is planning to split the post of executive chairman, presumably when incumbent Bill Moyes finishes his second term next January.

Mr Moyes has amassed considerable power and has aggressively defended foundation trusts against what he sees as DH interference.

He is not regarded warmly in the DH, and the antipathy between him and NHS chief executive David Nicholson is an open secret.

But whatever the motivation, splitting the post to establish a chair and chief executive is the right decision. In the age of good governance it is anomalous for any major public sector body, let alone a regulator, to place so much power in the hands of one post. Splitting it will send the right message to foundation trusts about the centrality of effective governance.

However, it must not lead to a weakening in the voice and independence of foundation trusts. Monitor took the DH at its word in professing its belief in autonomy, and has provided a competing centre of gravity in the NHS which has drawn the orbit of FTs a little distance from the DH. Although Mr Moyes’ tactics have occasionally been confrontational, his organisation has certainly worked to put a line in the sand which the DH crosses at its peril. This autonomy must be defended.