News / TSA powers to extend in planned law change

By Seamus Ward

The government has moved to extend the powers of trust special administrators (TSAs), allowing them to recommend changes across a health economy, rather than just the trust in administration.

Moving an amendment to the Care Bill, health minister Earl Howe said it would ‘put beyond doubt’ the question of whether TSAs had the power to make recommendations on services outside a trust in administration.

The TSA for South London Healthcare NHS Trust recommended a number of services at Lewisham Hospital NHS Trust be closed or downgraded, including its A&E department and maternity service. The plans for Lewisham were ruled unlawful by the High Court in July.

The Department of Health is appealing the ruling, but the Save Lewisham Hospital Campaign reacted angrily to the clause, which was accepted by the Lords at the end of October – a few days before the appeal was due to take place.

Louise Irvine, a local GP and the campaign’s chair, said: ‘The amendment gives them unlimited powers to destroy any hospital, in any geographical area regardless of how successful it is, or how desperately needed it is by that community.

‘It is very dangerous if politicians quite deliberately sweep away the checks, balances and full consultation processes that are needed in current legislation to restructure and reduce health services for the population.’

However, Earl Howe said the amendment would allow TSAs to do their job.

‘NHS trusts, foundation trusts and other providers do not exist in isolation from each other. They are part of a complex, interdependent, local healthcare economy. Issues of clinical and financial sustainability nearly always cross organisational boundaries.’

In a further change, the TSA would be required to consult with commissioners of all providers affected by its recommendations. And two stages of the administration process would be extended – the TSA would have 65 rather than 45 days to produce a draft report and 40 rather than 30 days for public consultation.

Commissioners and providers affected by TSA planned changes at Mid Staffordshire NHS Foundation Trust have been given an extra 40 days to reach agreement on the funding of essential services transferred from the trust.

Monitor said that the TSAs’ final report had been written and was waiting for the funding agreement.