Hugo Foxwood

S&P analyst Hugo Foxwood said Wellcome stood out from its U.S. peers, who could only borrow to fund capital expenditure.

Hugo Foxwood, credit analyst at Standard and Poor's, told Public Finance: ‘With a diversity of assets, its high political profile and government support, a Monitor mark II could attract a high investment grade rating, such as A+, or AAA.'

By comparison, S&P published a report earlier this year warning that the combined market uncertainties of payment by results and Patient Choice meant that lone foundations could be given the lowest investment rating of BBB-, just above ‘junk' status.

But Foxwood said much could depend on how much control a Monitor mark II had over trust revenues and expenditure.