Published: 03/10/2002 Volume II2, No.5825 Page 4 5

Health secretary Alan Milburn says he will stand 'four-square' behind managers trying to bring overseas clinical teams into the NHS.

Speaking to HSJ at the Labour Party conference, Mr Milburn said: 'We will stand four-square behind any hospital or manager who wants to bring more doctors into the NHS'.Asked if that meant backing them in the face of resistance from existing clinical staff, he said: 'If it is right for the local community.' Commenting on the unease felt by many in the medical lobby, he simply said: 'Doctors know we need more doctors.'

Last week, HSJ reported that the introduction of overseas teams into NHS hospitals had, among other problems, encountered resistance from UK clinicians.

Speaking in advance of his address to the conference on Wednesday (yesterday), Mr Milburn stressed that the Department of Health was trying to devolve power to tackle the 'sense of disempowerment and disengagement with health service reform among many NHS staff '. But he added: 'Local populations feel disengaged, too. We have a service which denies people choice, despite the fact we live in a consumer-orientated world.'

The power of the patient to influence how services were provided needed to be increased, he said. This was best done by giving them greater choice, 'not just by letting them sit on committees'.

The lack of ownership in local health services would also be tackled by the establishment of foundation trusts, claimed Mr Milburn. He dismissed as 'nonsense' the claim made by, among others, former health secretary Frank Dobson, that foundation trusts would lead to the privatisation of hospitals.

On Monday, the Transport and General Workers Union launched a report attacking the foundation concept as 'a dagger to the heart of the philosophy of universality', which represented a 'full-blown and giant step towards privatisation of the NHS' via the creation of two-tier systems.

But Mr Milburn insisted foundation hospitals would 'empower the local community and let local government have a greater say [in the running of hospitals].'

'Not for profit, community-centred' foundation trusts would allow the creation of a 'fourth centre' for British healthcare alongside the NHS, the private and voluntary sectors.

On the pace of reform, Mr Milburn warned: 'We have to have the courage to say that change takes time. We can't do this by magic - we do not live in Harry Potter land.'

On criticisms that reform meant the end of the service, he said it was 'absurd [to claim] that change meant abandoning the values of the NHS'. He was 'tearing his hair out' listening to Monday's debate on the private finance initiative.

'Private firms have always built NHS hospitals, ' he said. 'We have to have a more grown-up relationship with the private sector.'

In conclusion, Mr Milburn confirmed that the government had decided to raise the profile of public health.He said: 'I want to hold PCTs to account over the health of their population. I want to see as much accent on prevention as cure.'

Patient choice scheme prepares for expansion

Plans to expand the patient choice scheme to areas beyond cardiac treatment were due to be announced this week.

Health secretary Alan Milburn was expected yesterday to announce a national expansion of the scheme - which began in July with a six-month limit for cardiac patients - to cover other conditions.

The work is being pioneered by the£75m London Patients Choice project, which this week launched schemes for cataract patients - which went live a month ago - and promised future schemes for all adult surgical specialties.Much of the planning for the London schemes pre-dated the introduction of the government policy.

The London directorate of health and social care said all cataract patients approaching a six-month wait could opt for another NHS hospital for treatment.

Initially,3,500 will be treated, and a further 6,000 patients will benefit when the scheme is extended to orthopaedics, ear nose and throat and general surgery next April and in June 2003 to all adult surgical specialties.

Project director Martin Roberts said the Department of Health would examine the results when developing its ideas, allowing 'resources to follow the patient'- the concept first outlined in the post-Budget Delivering the NHS Plan.

Mr Roberts said 67 per cent of patients contacted have opted for treatment at another NHS hospital.