Dobson warns of fresh revolt on health reforms

Frank Dobson, the former health secretary, has warned that the appointment of a Scot to run the National Health Service in England will add to Tony Blair's difficulties in pushing through controversial reforms.

Rebel MPs are planning a second attempt to block legislation introduced by the former health secretary Alan Milburn, which would allow some of the top English hospitals to apply for foundation status, giving them greater control over their budgets.

The idea has been rejected in Scotland, where the NHS is controlled by the Labour-dominated Executive. It will now be up to John Reid, the new Secretary of State for Health, to push the legislation through in England. Mr Reid is a Scot who represents North Hamilton.

His appointment is one of several factors that could increase the size of the next rebellion on foundation hospitals, Mr Dobson claimed yesterday.

When the proposal to create foundation hospitals came before the Commons early in May, it triggered a revolt in which 63 Labour MPs voted against the Government. According to Mr Dobson, who led the revolt, there are a series of reasons why the next rebellion could be larger.

"There will be quite a lot of MPs who object that a Scot has been given the job of imposing on England what the Labour-run Scottish Assembly has rejected. There will be a lot of irritation about that," Mr Dobson warned yesterday.

"After the reshuffle, there will also be a few of them thinking that they are never going to get jobs after all, so they will vote as they think. Some of the dumped ex-ministers will start voting the right way now.

"And some of the Scottish and Welsh MPs who helped get the legislation through may vote against it now as their first chance to protest against what has been done to the Scottish and Welsh offices.

"So I am very hopeful that even if we can't defeat the idea, if it gets close the Lords will cut up rough about it."

The legislation that will bring foundation hospitals into existence is still being scrutinised by a Commons committee, but is expected to be brought back to the Commons early in July.

Opponents fear that the reform will create a "two-tier' NHS, in which patients in foundation hospitals are better treated than those in other parts of the NHS. They also fear that if a large number of hospitals take foundation status, the regulator appointed to keep a check on them will become too powerful.

The policy's supporters, such as Tony Blair and Alan Milburn, claim that it will push up standards in the health service generally by allowing more decisions to be taken by hospital managers rather than by Whitehall.