Britain yesterday announced that it is to take a leaf out of the Spanish health service's book and set up new NHS Foundation Hospitals based on the management model used at Son Dureta Hospital in Palma and the capital's new Palma II. The director of Son Dureta hospital, Luis Carratera, was in London yesterday attending the presentation given by Health Secretary Alan Milburn. Milburn and his team have been investigating how the foundation hospital system works on the mainland and in Majorca for the past year and has concluded that the foundation hospitals, and following the examples that have worked in Spain, will help to create a radically different health service in the UK. This year the Balearics was granted control of an autonomous health service, IB Salut, with greater powers and more independence from the Insalud National Health Service. However, for the time being, Milburn intends to free the UK's top NHS hospitals from Whitehall control. Based on the Majorca models, the new foundation hospitals will be trusts on which doctors, patients and the local authorities are represented with the aim being that hospitals are given the freedom to decide how they should be best managed. Hospitals in Cambridge, Norfolk, Northumbria and Peterborough are to join the first wave of the new foundation hospitals with others due to follow suit in July. Foundation hospitals will be able to enjoy far more independence within the NHS and be run as not-for-profit organisations. The hospitals will be accountable to their local communities and not to the Department of Health. The foundation hospitals have received a mixed response in Britain and the management model in Majorca is neither favoured by the Balearic government. On the one hand supporters believe that the foundations will allow hospitals to improve services to patients by being able to decide how to spend income from the state and give staff pay incentives. Those opposed to the plan fear that a two-tier system of foundation hospitals and second division hospitals will be created. The only answer is to offer the foundation option to all NHS hospitals, not just the top 30 performers, as currently proposed by Milburn. Very soon Majorcan nurses employed in the UK will be working in hospitals managed on the Majorcan model.

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