Doctors united in opposing plans for 'prestige' hospitals

Doctors, Labour MPs and trade unions urged the Government to slow its plans to create a network of prestige hospitals yesterday after one of Tony Blair's senior advisers warned that they could create a two-tier health service.

A survey by the British Medical Association (BMA) found more than eight in 10 doctors believe the introduction of foundation hospitals could make a two-tier system.

Eighty-four per cent of doctors think there is a danger some hospitals could lose if the Government goes ahead with its plan to allow successful hospitals to gain their freedom from Whitehall control.

The BMA says 86 per cent fear foundation trusts' ability to "reward staff appropriately" could erode nationally negotiated terms and conditions.

The issue will be debated at the BMA's annual meeting in Harrogate on Monday. Two motions have been tabled calling on the organisation to oppose the scheme.

The Government came under pressure to think again after The Independent disclosed that Adair Turner, a member of Mr Blair's "blue skies" Forward Strategy Unit, had recommended a delay until after the capacity of the NHS had been increased.

But Downing Street insisted the plans would not be delayed, saying: "This is about a process of levelling up, not levelling down, and it is about improving standards right across the board."

The Department of Health stuck to its goal of seeing the first wave of foundation hospitals set up by the end of next year. The Treasury, though, is understood to echo Mr Turner's caution on the planned timescale.

David Hinchliffe, Labour chairman of the Health Select Committee, said the Government would have difficulty ignoring a warning from such a senior adviser. "The points that Adair Turner is making are very relevant. Among many Labour MPs ... there are very real fears that we could have a two-tier system arising from the advantage being given to foundation hospitals."

John Edmonds, general secretary of the GMB union, which has thousands of members working in hospitals, said: "The trade unions have been warning for months that the Government's privatisation plans would lead to the fragmentation of the NHS, and Mr Turner has confirmed that view. If the Prime Minister will not listen to trade unionists, perhaps he will at least take note of his own adviser."

In the BMA survey, doctors expressed concern that freeing hospitals able to achieve the top "three star" performance rating would widen the divide with other hospitals.

John Wattis, a consultant in old age psychiatry in Leeds, said: "I think the whole thing is a terribly divisive idea. Everyone in the NHS needs a less centrally directed, more empowering style of management. Just giving this to the fortunate few, who for historical reasons are better off than the rest, will only increase inequality and reduce morale."

Bernie Bedford a South-ampton GP, said: "It's arguable that the people who most need freeing from central control are the ones that aren't performing so well. Those in difficulty may well get worse."