Frank Dobson MP: The reluctant rebel vowing to stand up and be counted

The Monday Interview: Former Health Secretary

The thunder is rattling around in the sky over Strawberry Cottage, Frank Dobson's rural Yorkshire bolt hole.

"It's absolutely f***ing pissing down," he says, beckoning us to come in from the torrential rain. Inside his weekend retreat, where Mr Dobson's family – including his railwaymen father and grandfather – has lived for more than 100 years, there is a cosy but faintly martial feel. Battle anthems blast through the house, and lightning flashes at the windows. Tea is served from triumphalist Labour "Victory" mugs.

But then the former health secretary is preparing for war. A seasoned political pugilist, he has stepped forward from the back benches to lead the charge against foundation hospitals.

The alacrity with which he rushed to defend the NHS has alarmed some on the government benches. Since Tony Blair was elected, Mr Dobson has been a staunch Labour loyalist, and until the war on Iraq his only rebellion was to vote against Church schools.

The bluff campaign veteran had been confining his sorties to attacking the far right and saving Hagg Wood where he walked with his father. But fearing the destruction of the NHS, Frank Dobson has been beckoned away from minor skirmishes to the national battle ground. Even now at least 100 Labour MPs, led by their bruiser general, are preparing to defy the Government in a rebel vote. Mr Dobson says members of Blair's Cabinet are among the doubters.

"If you look at the Parliamentary Labour Party, there is a very, very limited number of MPs who actually think foundation hospitals are a good idea,' he says. "There's another group of super loyalists who would vote for the Slaughter of the First Born Miscellaneous Provisions Bill if it came out of Downing Street, but the bulk of the parliamentary party – from cabinet ministers to the most back-marker backbencher - don't like the idea."

Mr Dobson fears that foundation hospitals are just the start of a Blair revolution of the NHS that will lead to patients being charged for services, given vouchers or made to take out private insurance.

He reels off a score of statistics to illustrate why removing some hospitals from central control and giving them the power to raise cash and poach staff from neighbouring hospitals will harm the sick. In Spain, where foundation hospitals are a reality, the main hospital received at least twice as many patient complaints as any other in the country. A study from Bristol showed that competition in the NHS made it harder for emergency heart-attack patients to get treatment.

But his opposition to the changes is based on more than statistics, it is ideological. Splitting away some hospitals will tear through the Labour ethos of a co-operative society and erode the foundations on which the health service was founded.

"There's an instinctive feeling among large numbers of Labour MPs and activists that this just has the wrong feel to it," he said. "Every aspect of the NHS and the party has been based on a co-operative approach and it is going to reintroduce a competitive approach. There is only one organisation united in support of this and that's the Conservative Party."

The foundation hospital blueprint is little more than a return to the Tory idea of making hospitals compete against each other for cash, he says, and he finds it hard to fathom why Mr Blair is so enamoured with a discredited concept. One of Mr Dobson's first moves in 1997 as Secretary of State for Health was to scrap the Tory internal market. He thinks Labour should stop flirting with failed Tory dogma.

"It's hard to see why a Labour internal market should be any more efficient and helpful than a Tory internal market," he says. "None of the people who advocate competition have any evidence that it improves things. It's all assertion by think-tanks who have never run a chip shop." Such "tinkering" would not only harm the NHS but damage Labour, which had always been seen as the party of the health service. Copying Tory ideas would shrink the ideological gap between Blair and Iain Duncan Smith even further.

"Up until now Labour is associated favourably in the mind's eye of the public with the National Health Service which, after all, is the most popular institution in the country. We are associated with defending it and sticking up for it," he says. "There aren't that many clear ideological distinctions in British politics any more, and that is one of the few and if you keep on reducing them then it could be harmful to the party."

Mr Dobson is something of a reluctant rebel. He joined many of his colleagues to defy the Government over Iraq – symbolically sitting next to Robin Cook as he made his resignation speech. Yet he resists invitations, unlike other more disgruntled former ministers, to become a serial critic.

"I would much rather be saying what excellent things the Government is doing and attacking the Tories," he says. "I spend nearly all my time praising the Government, but I will vote against this because I think it is wrong, and it represents a fundamental challenge to the whole basis on which the health service was founded and on which it is operated."

Mr Dobson, who has been MP for the north London seat of Holborn and St Pancras since 1979 and, before that, ran Camden council for Labour, says the changes being proposed by his successor, Alan Milburn, have no mandate with the Labour Party or the people of Britain at a general.

"This proposition was being discussed privately before the general election but was never put to the electorate, so we have no mandate for it from the public," he says. "The immediate problem is it has never been approved by the Labour Party. It has never been agreed by any policy-making body in the Labour Party because it has never been put to any."

The Trotskyite ideal of permanent revolution was not good for the NHS, which had faced waves of reform for more than 30 years. Time was needed for the reforms to bed down and translate into improved patient care, he says. The NHS should be left alone to allow doctors and nurses get on with their job. Not only the NHS but also the Labour Party need time to recover from the trauma of change. After the Iraq war Mr Blair should give the party time to tend its wounds, not launch another offensive.

"It would be easier if the Government didn't try and open a second front against the party," he says. "It's a time for trying to keep people on board, not for pulling up the gangplank." But Mr Dobson, 63, is on familiar terms with the ruthlessness of Labour. He was humiliated by the leadership after agreeing to give up his cabinet job to run for London Mayor. He refuses to talk about it – but later smiles and says: "I am in denial."

THE CV

BORN: 15 March 1940

1951-1957: Attends Archbishop Holgate's grammar school in York

1957-1961: Undergraduate at the London School of Economics

1962-1970: Assistant Secretary for Central Electricity Generating Board

1970-1975: Administrative Officer for the Electricity Council

1971-1976: Councillor on Camden Borough Council

1979: Becomes MP for Holborn and St Pancras

1981-1997: Labour frontbench spokesman

1997-1999: Secretary of State for Health

1999: Agrees to run as Labour's first candidate as London Mayor.

2000: Finishes third behind Ken Livingstone and Steve Norris.