Plans to name and shame failing hospitals and subject their management to "special measures" similar to the tough regime imposed on failing schools were announced yesterday by the health secretary, Alan Milburn. In a move that signals the possible closure of poorly run hospitals, he also promised greater freedom for the best health providers to organise their services with minimum interference from ministers and officials.
He said his national plan for reforming the NHS would include a new system for scoring hospitals, health authorities and primary care providers and publishing performance tables to give patients clear information about the quality of service and efficiency of care.
Mr Milburn told the NHS Confederation conference in Glasgow that all health organisations in England would be measured on a "balanced scorecard" of performance and publicly classified green, amber or red.
The green category would be reserved for excellent providers that would have greater freedom of manoeu vre. For example they might be allowed to receive funding as of right without having to bid or seek approval from NHS regional controllers.
"They would be free to determine pace of change locally and they could be deployed to help the amber and red trusts improve their performance," Mr Milburn said.
At the other extreme, unsatisfactory hospitals and GP care groups in the red category would face "a sequence of escalating interventions". The national plan, due for publication in three of four weeks, would spell out how red organisations would receive "new expert external advice, support and where necessary intervention to help frontline staff redesign services from the patients' point of view".
It is the first time health ministers have used the term "special measures" devised by the Department for Education to describe intervention against failing schools, including the threat of closure if standards are not raised sufficiently within 18 months.
Mr Milburn said he was not yet ready to spell out the consequences for hospitals in the red category that did not respond to treatment. But it would be surprising if they did not in clude closure or a fresh start under new management.
During questioning from health service managers, Mr Milburn was asked if patients living near red-status hospitals could have confidence in the quality of treatment they would receive during the period of special measures. He said he did not intend to shame the organisations concerned, but it was not fair to patients if he got information about the performance of their health providers that they were denied.
"I want to move the NHS from a position where we bail out the bad to one where we reward the good," he said.
