Alan Milburn's concordat with the private health industry, announced today, is designed to make best use of the country's health resources.

The Government hopes that the use of private beds, operating theatres and personnel will cut waiting lists and avoid another familiar winter crisis.

Even though Mr Milburn has sought to present his plan as a matter of simple commonsense, Labour's old guard will find it hard to swallow. Many regard it as privatisation by the back door.

But those ideological objections may not be the only stumbling block that the Health Secretary has to overcome.

Outline

The concordat covers three main areas: elective surgery, critical care and intermediate care. The last category covers such things as post-operative rehabilitation, when patients sometimes block hospital beds because there's nowhere else for them to go.

Lack of communication

But the World at One has been given details of a survey by the National Association of Care Homes, suggesting that two-thirds of its 15,000 members have not yet been approached by the NHS to see what help they might be able to provide.

Only 8 of the 24 areas covered by the association reported having had serious discussions with Health Service managers about the provision of beds this winter.

One nursing-home manager in Essex, Mr Chinnock, told the programme that there was still a cultural problem within the NHS, inhibiting co-operation with the private sector.

Closures

The Association also warned that care homes had been closing at a rapid rate - and might not be there when the Health Service needed them.

When we asked Alan Milburn for his comments, he agreed that there might be cultural resistance in some areas. But he was convinced that overall the concordat would provide a better deal for patients.

The NHS Confederation - representing trusts and health authorities - welcomed the new arrangements - provided they remained at the margins.

More staff still needed

Its Chief Executive, Stephen Thornton, told us that the need for new surgeons, doctors and nurses remained as great as ever. Many of those who work in the private sector are in fact NHS staff. Consequently, the concordat would not of itself create new facilities.