Internal market attacked as 'Maoist', 'eccentric', 'poorly managed'... true cost of white paper... waiting lists grow

The internal market reforms were 'almost like a Maoist revolution', Commons social services committee chair Frank Field told health

secretary Kenneth Clarke. The NHS management board had rejected the idea of an internal market three years ago, Mr Field said. Mr Clarke replied: 'I don't recall that advice. I wasn't in the department in 1986.'

The joint consultants committee has dismissed the government's proposals as 'eccentric'. At its first press conference, JCC chair Sir Anthony Grabham said: 'We think the timescale is wholly unrealistic. Even if there was time, there is not the money to introduce the additional bureaucracy. And if there was the time and the money, we still think implementation would damage care of our patients.'

Health economist Alan Maynard said the reforms would erode the NHS and create a larger private sector. If this was not the government's intention, its review of the service had been poorly managed by politicians and civil servants, he said.

The total cost of launching the Working for Patients white paper was£1.4m, not the£1m originally estimated, the government has revealed.

The government's 'relaxed' approach to community care was in marked contrast to the 'breakneck pace' with which it was forcing through the

white paper proposals, said shadow health secretary Robin Cook. The year since the Griffiths report had seen 'no response, no action, and little active

consultation'.

Waiting lists have topped their highest level since 1984 and could be approaching the peaks of 1979. Figures released on Budget day show a 4.5 per cent rise to 691,000 between March and September 1988. That excludes 159,800 day cases and 40,800 self-referred cases.