Hospitals could be freed from government control

Opposition to foundation hospitals is "strange" and contrary to the need to modernise and improve the NHS, Tony Blair has argued.

The prime minister said all hospitals will be given a target date to become an NHS foundation trust and people "will look back and wonder what the controversy was about".

Health Secretary Alan Milburn said the plan to free some hospitals from government control "has never been about two-tierism, it's about raising standards everywhere".

And ahead of Wednesday's Commons vote on the issue, which could see a significant Labour backbench rebellion, Peter Mandelson said the proposals were needed to meet extra demands on the NHS.

'Control freakery'

Mr Blair spoke out after at least 130 of his MPs and unions said the creation of foundation hospitals would lead to great differences in the standard of care offered within the NHS.

You can't run the National Health Service is if it's the Chinese Red Army from an office in Whitehall Alan Milburn

Writing in the Observer, the prime minister said: "One of the strangest aspects of this argument is that the government is being attacked for putting front-line health staff and local communities in the driving seat in the NHS.

"When the criticism comes from many who for the past six years have accused this Labour Government of control freakery or worse, then it is stranger still."

Mr Blair said every hospital would be encourage to work towards becoming an NHS foundation trust and that he hoped the transition would be complete "within a short period of time".

'Red Army'

Mr Milburn told BBC1's Breakfast With Frost that he understood the plans were controversial, but that foundation hospitals would raise standards for all patients.

He said: "Ultimately you can't sustain these improvements unless you get the power out there to the local staff who provide the services and unless you get a greater say for the local communities who get those services."

We are tired of being told that the leadership knows best - that they only have to utter the word reform and we roll over George Mudie

Turning on the critics he said: "You can't run the National Health Service as if it's the Chinese Red Army from an office in Whitehall."

Mr Milburn denied the size of Wednesday's expected revolt would rival that seen over the Iraq war and that Mr Blair's position as prime minister was safe.

Continuing the government offensive, former Labour cabinet minister Peter Mandelson said hospital staff had to be given more power in order to bring about improvements.

He said standards and output in the NHS had to be doubled.

Mr Mandelson asked: "Are people really saying that we can do that using the same structures and the same systems that were invented in my grandfather's time in the 1945 Labour government under Clement Attlee?"

'Real danger'

Some Labour MPs opposed to foundation hospitals say they are simply a re-branding of Mrs Thatcher's NHS trusts and that they will not back down before Wednesday's vote.

Chancellor Gordon Brown prompted claims that he was against the reforms when he failed to allay the fears of MPs on the Treasury select committee.

Labour MP and former minister George Mudie warned there was a "real danger" of the government being defeated in the vote.

Mr Mudie said: "We are tired of being told that the leadership knows best - that they only have to utter the word reform and we roll over."

Liberal Democrat MPs have already announced their opposition to the reforms, while Tories have told the government not to count on their support.