Labour MPs opposed to plans to make top NHS hospitals more independent have been given a "tough message" by Health Secretary Alan Milburn.

the price for investment is radical reform Alan Milburn Health Secretary

Mr Milburn told the weekly meeting of the Parliamentary Labour Party the government had taken a risk in pushing up taxes to improve healthcare.

A senior Labour official said Mr Milburn had said "the price for investment is radical reform" as he defended the foundation hospital plans.

More than 100 MPs, most of them Labour, have signed a parliamentary petition warning the proposals would create a "two-tier" NHS.

Former Health Secretary Frank Dobson is among leading critics who say the plans are "elitist" and follow a "Tory consensus".

Change 'essential'

Under the plans, "three star" hospitals would become independent not-for-profit organisations, accountable to their local community rather than the government.

Up to 12 hospitals could seek the new status in coming months, with the first foundation hospitals up and running by spring 2004.

But Mr Milburn told MPs on Wednesday that it was difficult to accept that the NHS, which Labour held so dear, had to change.

Allowing some hospitals freedom from Whitehall control would give communities more public ownership of local healthcare services, not less, he argued.

Mr Milburn insisted the NHS needed the best management possible, whether it was in the public sector or came from private firms.

A Labour Party spokesman said: "There was an interesting discussion.

"I would not be telling you the truth to say that everybody believes in the policy that we are pursuing, but once people are talked through the arguments, they will see that this is a set of reforms that is coming from the left."

The plans have reportedly caused divisions between Mr Milburn and Chancellor Gordon Brown.

The Conservatives have criticised the proposals for not going far enough, saying all hospitals should be given more freedom.

Safeguards

The Liberal Democrats warn that giving extra powers to some hospitals will cause the "ghettoisation" in the NHS.

In what was seen as an effort to reassure critics on his own benches, Mr Milburn last week announced a series of safeguards for foundation hospitals.

There would be strict caps on how many private patients they could treat.

They would also have to operate under strict rules preventing them from destabilising the NHS in their area, said Mr Milburn.

He said they would be prevented from poaching staff from other hospitals or undercutting them on treatment costs.