Report on 2013 accountability hearing with Monitor

The Health Select Committee published its report on Monitor's 2013 accountability hearing.

The committee outlined that Monitor had an exceptionally challenging role, but that the Department of Health was pleased with the way Monitor was managing the transition to its new functions. However, the committee was critical about the clinical input available to the organisation, noting that the appointment of a medical director had been delayed for 7 months by the Department of Health due to a dispute over pay.

The committee welcomed the fact that the government had abandoned its target that the majority of aspirant trusts should become foundation trusts in 2014.

The committee noted that foundation trusts were under closer supervision and scrutiny by Monitor than ministers had previously envisioned. It outlined a risk that 'heavy handed' regulation could become an obstacle to change.

The committee suggested that the government should reconsider its decision to allocate responsibility for the financial regulation of social care to the Care Quality Commission (CQC) and that it would be more appropriate for Monitor to undertake this role.

The committee felt that the tariff arrangements created perverse incentives for providers and that Monitor should attach higher importance to develop revised NHS tariff arrangements.

The committee also expressed some concern about the uncertainty around NHS merger decisions and the effect of competition law on institutional change.

The committee noted that the health and care system was not changing service models quickly enough and described the pace as 'glacial'. It also noted that the financial pressures faced by NHS providers would be extremely challenging in the short term.