---

Health Bill [Lords]

In the legal context, Monitor, as the authorising body of foundation trusts, would be responsible. The public could, of course, be involved and one hopes that a foundation trust would have developed better mechanisms for public engagement and consultation. Any information that came through that route would inform any decision that Monitor reached. As I say, Monitor is the decision maker in this context. The administrator would review and consult patients and staff on the organisation's future and then make recommendations to the Secretary of State. We believe these measures will provide protection against the possibility of NHS providers continuing indefinitely. The National Health Service Act 2006 placed restrictions on the amount of income foundations trusts can earn from private patients. The private patient cap is automatically set at the proportion of private patient work a trust did in 2002-03. It was introduced because of the understandable concern that foundation trusts might expand private patient activity at the expense of the NHS. These concerns are still relevant today. Private care must not be delivered on NHS premises to the detriment of NHS patients, but the implementation of the cap has raised complex issues for some foundation trusts, which need to be resolved. An amendment was tabled in the other place to give the Secretary of State the right to grant exceptions to the rule that limits the amount of income a foundation trust can generate from private work, but I do not believe that this is the right solution. Striking the right balance between protecting NHS services for NHS patients and allowing foundation trusts the flexibility they need to operate in the interests of patients is a complex issue. There is no quick fix to implement, particularly without widespread consultation with the NHS.