Labour MPs rebel over NHS plans

Three-star trusts like Guys could become independent

Government plans to give top-rated NHS trusts more independence have come under attack from Labour MPs.

As many as 45 backbenchers defied ministers to vote against plans to introduce foundation trusts on Wednesday.

The vote came at the end of an opposition day debate in the Commons on the new hospitals.

Opposition parties had earlier criticised the proposed foundation hospitals saying the policy was muddled and had not been thought through.

The whole thing smacks of being made up as it goes along

Dr Liam Fox, Shadow Health Secretary

A Tory call for the government to allow all hospitals to bid for foundation status was defeated by 381 votes to 144.

However, the government's majority fell to 132 just minutes later as a motion welcoming the principle of NHS foundation trusts "providing care to NHS patients according to NHS principles" was backed by 282 votes to 150.

The 105 vote difference in the majorities was almost certainly caused by Labour backbench abstentions.

The first wave of foundation trusts are scheduled to be named during the summer. These hospitals will be able to set their own clinical and financial priorities for the first time without interference from Whitehall.

They will be modelled on similar hospitals in Denmark, Spain and Sweden and will be run on a not-for-profit basis.

Tory support

Speaking in the Commons earlier, shadow health secretary Dr Liam Fox said the Conservatives backed the foundation trust model.

However, he said he was concerned the government would not go far enough and that the trusts would not be truly free.

He accused ministers of being divided on the issue.

Mr Milburn wants to free top-rated trusts

"There is a fundamental split between those who believe they have to deliver at any cost and those who believe that delivery is more important," he said.

Dr Fox also accused the government of failing to think through its foundation trust policy.

"The whole thing smacks of being made up as it goes along," he said. "It is a panic response from the government that feels it has to produce reform."

'Muddled' policy

The Liberal Democrats accused government NHS policy on the NHS of being muddled.

The party's health spokesman Dr Evan Harris said: "The more Alan Milburn describes his foundation hospitals policy, the more muddled and inconsistent it becomes.

"In trying to please the right wing free marketers in 10 Downing Street, at the same time as appeasing Labour rebels loyal to 11 Downing Street, he is trying to have it both ways and ending up satisfying no-one."

Former health secretary Frank Dobson urged ministers to abandon the policy.

He said: "Ignore this individualised specialised treatment for a limited number of privileged hospitals, which are bound to bring about a two tier service which will damage the NHS and blur the distinction between our party and its wonderful record on the health service and the Tories and their abominable record on the health service."

Labour opposition

Labour MP and chairman of the influential Commons health committee David Hinchliffe also raised concerns about the policy.

He said foundation hospitals could act as a "Trojan horse" for a future Tory government to re-introduce a two-tier health service.

He urged ministers to listen to disquiet among Labour MPs and await results of an inquiry by his committee before proceeding.

Independent MP Dr Richard Taylor, who was elected at the last election after campaigning against down-grading of health facilities in his constituency, also criticised the proposals saying it would create a two-tier NHS.

A large number of Labour MPs are opposed to the policy. More than 100 MPs, most of them Labour, have signed a parliamentary petition warning the proposals would create a "two-tier" NHS.

But speaking in the Commons, Mr Milburn dismissed those claims. "The reverse is the case," he said.

Mr Milburn said the changes would help to improve standards across the NHS.

He also accused the Tories of wanting to privatise the health service.

"Their programme is cutback and closure. Labour's programme is investment plus reform. It is this programme which will deliver improvement in the NHS."