Trust chief executives' reflections on self‐governing

Abstract

This article reports the views of UK Chief Executives of Self‐Goveming Trusts (SGTs) on the benefits and disadvantages of the reforms of the UK National Health Service (NHS), namely the Internal Market, which arguably originated with the 1983 Griffiths Report (Griffiths, 1983, NHS Management Inquiry) and culminated in the Government White Paper, ‘Working for Patients’ (Department of Health, 1989). The views of SGT Chief Executives on their experience of, and reasons for, their care facility opting‐out of health authority control are summarised. The July 1996 questionnaire surveyed those Trusts that had gained self‐governing status between April 1991 and April 1996. The research investigated the issues of finances, resources and the effects of SGT status on the relationships with, and roles of, district health authorities, regional health authorities, the Department of Health, staff and patients. The article provides an overview of moves to SGT status and highlights prior aims and reflections through the eyes of Chief Executives. The responses reflect a general satisfaction with, and positive response to, SGT status, especially in regard to the greater freedom in managing their own affairs and a belief that the service had become more responsive to patients. The perceived problems of the Internal Market arose from uncertainty over income, pressure on staff, and vulnerability to political change, the latter concern relating to the then forthcoming 1997 general election and to pending health reforms.