Milburn hits back at Blair adviser over two-tier NHS

Alan Milburn has hit back at the senior adviser to Tony Blair who called on the Government to delay plans to create a wave of prestige hospitals.

The Health Secretary fired a broadside at Adair Turner, a member of the Prime Minister's "blue skies" Forward Strategy Unit, who has warned that plans to free high-performing hospitals from Whitehall control could lead to a two-tier National Health Service.

Mr Milburn told a conference of NHS staff in Birmingham yesterday: "Reform is central to the renewal of the NHS and our foot should be on the accelerator, not, as some would argue, the brake." Rejecting what he called the "voices of scepticism" on the Government's health strategy, he said: "I know those doubters are wrong. Our job is to prove them wrong."

With Mr Blair's backing, Mr Milburn vowed to press ahead with plans for foundation hospitals. He rejected Mr Turner's warning that the scheme should be delayed until NHS capacity had been increased.Mr Milburn said patient choice would be enhanced at the same time as there was "a sustained expansion in capacity".

Although Mr Turner backed the idea of foundation hospitals in the long term, he warned against introducing them too quickly. But one government source responded: "Blue skies thinkers should have the courage of their convictions."

The Health Secretary promised that hospitals winning foundation status would be free from Whitehall direction and control. "It is right that standards are set nationally, but it is wrong to try to run the NHS nationally," he said. "Where there are persistent problems we will step in. Where there is progress we will step back."

Mr Milburn also used his speech to offer NHS workers higher pay in return for "an end to old-fashioned working practices" and the breaking down of "outdated professional demarcations". Talks with staff other than doctors, whose contracts are already being renegotiated, will start shortly. Mr Milburn said: "It will mean an NHS where staff are paid according to the work they do, not the job title they hold. So that the senior nurse who takes on more responsibility gets more pay. So that the clerical officer who provides support for a large clinical team gets paid more than the administrator who is in charge of more routine work."

The Health Secretary added: "I have never agreed with those who say that we have to choose between investing in staff or investing in services. In the NHS they are one and the same."

Mr Milburn defended his plans to allow health providers in France, Germany and Sweden to bring their clinical teams to Britain, proposals opposed by some consultants. "What we cannot have – and what I will not accept – is anyone having a right of veto on NHS patients getting the extra doctors they need."

John Edmonds, leader of the GMB union, dismissed Mr Milburn's talk of partnership with NHS workers as warm words. He said: "The Government's privatisation plans have been condemned by NHS patients, NHS staff and even Number 10's own NHS adviser, yet the reaction of ministers is to carry on regardless."