11 July 2003
Government plans to introduce NHS foundation trusts were hanging in the balance despite this week's narrow victory, after a furious Commons' debate on the issue.
Opponents of the controversial initiative vowed to step up their campaign after the government's majority was slashed to 35 votes on July 8 as it fended off a motion to remove sections from the Health and Social Care Bill that would create foundation trusts.
The vote came after a day of intense pressure from government whips and the granting of concessions. These included an amendment ensuring the new independent regulator for foundation trusts will report to the Commons.
The Department of Health insisted the Bill was on schedule to create the first wave of foundations next April. The Bill will now pass to the House of Lords in the autumn where it is almost certain to be amended.
However, the controversy will not die down over Parliament's summer recess. Opponents include former health secretary Frank Dobson, Commons health select committee chair David Hinchliffe, the British Medical Association and Sir Bill Morris, former general secretary of the T&G union.
In the wake of the Commons vote, public sector union Unison vowed to force a debate on the issue at September's Labour conference in Bournemouth.
'The government is in for a bumpy ride over the summer as opposition swells. And Unison will take the fight into the heart of Labour at its conference,' said Unison's head of health, Karen Jennings.
'We all want to see reform in the NHS, but foundation trusts are a risky experiment that the public can ill afford. Instead of focusing on patients, foundation trusts will be forced to waste valuable time and resources preparing applications, filling in forms and pawing over the small print in contracts.'
Prime Minister Tony Blair urged a meeting of Labour backbenchers on July 9 – the day after the revolt – to unite and end the infighting that was threatening the government's programme.
His official spokesman said the hospitals policy remained an important plank. 'What people want on the ground is both national standards and local flexibility,' he said.
During the Commons debate, Hinchliffe said foundation trusts would create winners and losers.
'The last thing that our health care system needs is further restructuring and change, especially ill-considered change that has not had its potential consequences worked through.
'There have been 18 significant restructurings of our health care system during the past 20 years. People ask me where all the money has gone – it has gone on many of those restructurings,' he added.
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