Adviser warns over NHS funding

Public services are a key political battleground

One of the prime minister's top advisers has warned that the billions of pounds being spent on the NHS may fail to deliver the improvements the government wants.

A leaked report from the head of the Downing Street delivery unit suggests the health service will fail to achieve key targets such as reducing hospital waiting lists because the money is not being spent properly.

Michael Barber's confidential report says there is an "immense risk" the NHS will fail to take advantage of the government's record spending on healthcare.

The money is not being wasted. It is going into the National Health Service

Prime Minister Tony Blair

His report, which was leaked to the Financial Times, expresses concern that trusts are using the extra money to pay off debts.

The report also blames a lack of planning saying there has been little forethought on how the extra funds should be spent.

Key targets

Mr Barber said that while targets for this year will be met, improvements earmarked for 2005 will require a different approach.

This year's targets include ensuring no-one waits more than 12 months for an in-patient admission.

By 2005, no one should be waiting longer than six months for an operation.

Alan Milburn's reputation is on the line

Mr Barber's comments were seized upon by opposition parties, who claimed that the extra money is being swallowed up by bureaucracy.

But Prime Minister Tony Blair dismissed such suggestions.

Speaking in the Commons, he said: "The money is not being wasted. It is going into the National Health Service.

"The extra money is providing new buildings, new equipment, more nurses, more doctors.

"It means that every single national in-patient waiting indicator is below what it was in 1997.

"The delivery unit does not say the position is worse in the National Health Service, it says rightly that we have to make sure that when we are putting this extra money in it is used well and wisely and it is."

However, the British Medical Association backed the reports findings.

A spokeswoman said: "We have certainly had anecdotal reports from consultants who are trying to drive through change and innovation but complain that the new money for the NHS has not yet reached their hospital or unit.

"Some have complained that the new money is being swallowed up in settling old debts."

Political response

Shadow Health Secretary Dr Liam Fox said: "Downing Street has finally woken up to what everyone else has known for years: If you pour huge and increasing amounts of taxpayers' money into the NHS without genuine reform, it makes virtually no difference to the healthcare that the British people receive."

Dr Evan Harris, Liberal Democrat health spokesman, said: "Labour's dirty secret is out. Ministers know that the resources they have put in to the NHS have come too late for patients who were promised quicker treatment and access to new drugs."

Labour MP David Hinchliffe, chairman of the Commons health committee, said: "There are some worrying points in respect of the scale of organisational change.

"But there is a better quality of work, and much more stringent clinical standards than there were previously."