Mid Staffordshire is the first foundation trust to be declared bankrupt. The hospital that made national headlines when hundreds of patients died due to poor care over a four-year period from 2005 to 2009 has called in the administrators.

‘Does this mean that, however well managed, some hospitals are just not viable?’

The Francis report identified an obsession with gaining foundation status and a focus on finance at the expense of care as a reason behind the poor care at Mid Staffs.

Now it would appear that as the emphasis has shifted to ensure best care practise, the trust has followed a path of overspending. Last year the government was forced to bail it out with a £20m one-off payment and it is going to have to do it again this year. Does this mean that some trusts either stay within budget and people die or provide excellent care and go bust?

Merge or bust?

In which case does this mean that, however well managed, some hospitals are just not viable? The administrators at Mid Staffordshire appear to think that the population it serves can’t support this size of trust and that specialist services and patients needing serious care will have to be sent to Wolverhampton or Walsall.

This would appear to mean that foundation trusts need to merge or risk going bust. If you go bust then your high-status specialist services, the ones that bring in the big money and the prestige, are transferred and local people have to travel further to access these services.

So the business model is one of completive takeovers. You can see why Leeds is fighting so hard to retain its specialist children’s heart unit.

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