By Chris Hogg BBC Health Correspondent

Will it lead to more freedom?

"I know you have been talking about them all week, but I still don't understand what a Foundation Hospital is exactly, and why I should care anyway?"

I fear my colleague in the newsroom is not alone, baffled about a story which has led the bulletins for days, and yet leaves most people at best confused, at worst disinterested.

I for one am not going to try to predict what a Foundation Hospital will actually turn out to be like

Political hacks portray this issue as a totemic struggle between old and new Labour.

For MPs who oppose the policy like the former health secretary Frank Dobson and the chairman of the health select committee David Hinchliffe it is clearly a principle that annoys them enough to spend a lot of time and effort campaigning about it.

But I for one am not going to try to predict what a Foundation Hospital will actually turn out to be like.

Many questions

For a start, as the Health Select Committee has pointed out, the government's attempts to spell out the detail of its plans leave most observers with more questions than answers.

The policy has changed significantly in recent months, most notably with the decision to extend it to all NHS hospitals within five years.

There will no doubt be further tweaks in months to come, building on the experience of the first wave of Trusts which are due to be created next April.

So that brings us to the second question. Should we care?

Well just how different will Foundation Hospitals be allowed to become?

Well, the proposals have been watered down substantially in the face of opposition from Messrs Dobson, Hinchliffe and it appears, the Chancellor.

The government has not yet made clear whether or not the plethora of targets NHS hospitals have to meet will apply to Foundation Trusts or not.

Will they be exempted? If not, then will they end up having much more freedom at all?

If that wasn't enough there are all the people they have to answer to (and the bureaucracy that goes with that process).

Simple question

NHS hospitals are accountable to the Secretary of State, the watchdogs who carry out inspections and the local NHS organisations (the Primary Care Trusts) who buy care from them on behalf of their patients.

Foundation Trust managers will be accountable to the new independent regulator instead of the Secretary of State, the new beefed up inspectorate the Commission for Healthcare Audit and Inspection, the PCT's AND each hospital's new board of governors made up of patients, members of the local community, staff, Old Uncle Tom Cobley and all.

So not much more freedom there then.

While we are on the subject it is still not clear how much power this last lot will wield.

When they were compiling their report the MPs asked the Department of Health a pretty straightforward question in an attempt to find out.

If a Foundation Trust's managers came up with a plan to reconfigure their facilities (i.e. close a unit or a hospital) would the members of the Foundation Hospital (those members of the local community who have taken out membership to elect the board of governors etc) be able to veto that closure?

some people argue that attempts to sell this policy as a more democratic way to run the health service are a bit dubious

After all closure is the C-word which most exercises local newspapers, politicians, and local people.

A policy that devolves power to local people meaningfully would surely give them more opportunity to prevent unwelcome closures of facilities.

It appears not. In reply to their question the Department told the committee that if they were unhappy with the managers' policy, the members of the Board of Governors could vote to sack the directors of the hospital if they managed to secure a 75% majority for the decision.

That wouldn't mean necessarily that the decision had been vetoed.

So local people who join in and become members of a Foundation Trust in the hope that they will get a real say in how the hospital is run, may end up disappointed.

Is it democratic?

In fact some people argue that attempts to sell this policy as a more democratic way to run the health service are a bit dubious.

When Foundation Hospitals draw up their membership they can decide their own electoral boundaries in the local community.

Local councils and MP's electorates are decided by the Boundaries Commission.

The process of managing the elections of the hospitals' governors has not been set down centrally.

There's no obligation on hospitals to proactively recruit members in the local community.

Will it be in manager's interest to spend time and money trying to recruit people for membership, people who could in the end make their life more complicated?

What do you think?

Until these questions are answered it will be difficult to gauge the impact of Foundation Status will have on the patients treated in these hospitals and those treated in hospitals down the road.

There is an argument however that those Labour rebels who fear they augur the end of the National Health Service as we know it have turned their fire on the wrong target.

The new arrangements for commissioning care, summed up as 'the money follows the patient', the moves towards more patient choice, these policies are already in place and represent more fundamental reform of the NHS.

The Health Secretary denies that he has reintroduced the Conservative's internal market and all the iniquities that came with it.

But some commentators do not see it like that and question why an idea that Labour disliked so much in opposition that it abandoned it once it came into power now appears to be flavour of the month again.