New plans give all hospitals a chance of foundation status

Abandoning controversial plans for foundation hospitals would be a mistake "of historic proportions", Tony Blair has said.

The prime minister used a speech in central London to step up his efforts to stave off a backbench Labour revolt over health service reforms on Wednesday.

He is facing stiff opposition from Labour MPs over the introduction of the elite hospitals, which will be free from Whitehall control and have their own fund-raising powers.

In an attempt to answer accusations that the changes will lead to a two-tier health service, the government is to allocate an extra �200m to poorly performing hospitals to help them gain foundation status.

For those who believe in public services, reform is fundamental to their future Tony Blair At-a-glance: Foundation hospital plans

More than 130 Labour backbench MPs have signed a parliamentary petition against the proposals, although the number is expected to fall in the first Commons vote.

Mr Blair said: "For those who believe in public services, reform is fundamental to their future, to turn our backs on it would be a collective mistake of historic proportions."

Mr Blair acknowledged that foundation hospitals had dominated the public service reform debate.

He added: "In reality it is only one part of a series of changes we need to make."

Others included bringing in new providers, from the NHS, private services or abroad; and giving patients "real choice to go elsewhere for treatment, paid for by the NHS if they are waiting too long."

Mr Blair said the "one-size-fits all" system for public services had to change and he pointed to the tax rises to fund extra health spending.

"The public has paid its money, it now expects the results," he added.

'Mistake'

Health Secretary Alan Milburn earlier briefed journalists as part of ministers' concerted effort ahead of Wednesday's second reading debate on the new health bill.

Mr Milburn said he was confident ministers would win the vote and he denied the plans repeated the Conservative policy of the internal market.

"Reform is not about abandoning the principles of the NHS ... it is about making those principles work for the world in which we live today," Mr Milburn went on.

I don't think bringing �200m forward at this very late stage is a good piece of evidence-based research Tony Lloyd Labour MP

An unreformed health service would be a weaker institution and would lie open to a Tory agenda of cuts, he argued.

He also dismissed claims the plans would produce a "two-tier" health service, saying the idea was to ensure no hospitals were "left behind".

Also on Tuesday, ministers released a document - the NHS Improvement Programme - detailing how they intend to help all hospitals in England to achieve foundation "three-star" status within five years.

'No magic wand'

A fund of �200m will be available along with support for managers for those hospitals judged to be below the required standard.

The publication is being seen as another attempt to persuade Labour's backbench rebels to back down, but was branded a "bribe" by public service union Unison.

Former Foreign Office Minister Tony Lloyd BBC Radio 4's Today programme: "I don't think that in itself is particularly helpful... that bringing �200m forward at this very late stage is a good piece of evidence-based research."

Mr Lloyd feared that making "the best better" would make top hospitals "uncatchable" by the rest.

Tory vote in doubt

TGWU general secretary Bill Morris has written to Mr Milburn warning that foundation hospitals could wreck a deal on pay and conditions agreed last November after four years of negotiations.

And the Labour chairman of the influential Commons Health Committee, David Hinchliffe, condemned the scheme as "directly contrary to everything the Labour Party has stood for since it created the NHS in 1948".

In a report due on the morning of Wednesday's vote, Mr Hinchliffe's committee is expected to warn that foundation trusts will attract staff, patients and funding away from other hospitals, harming the rest of the NHS.

The government can not count on the Conservative vote to push through Wednesday's vote after Iain Duncan Smith indicated they might not support the "messy" legislation.

Liberal Democrat health spokesman Evan Harris said his party would vote against the plans, which were a "mock decentralisation" which would prove divisive.