Cabinet furious at Dobson over gaffe on NHS charges gaffe

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Frank Dobson's refusal to rule out new charges for the NHS, which provoked the wrath of Cabinet colleagues and medical organisations, was blamed yesterday on the existence of current hospital charges which penalise the poorest patients.

Ministers were furious with the Secretary of State for Health for a gaffe over the possibility of charging for visits by the family doctor, which plunged the Government into its first serious row since the election and opened Labour up to Tory charges of "betraying" the voters.

Mr Dobson's reluctance to clear the air on charges was attributed to the little-known practice under which the poorest patients are charged for long-term care by making deductions from their benefits, while others who are better off receive it free.

The existence of the anomaly makes it a prime candidate for consideration in the Government's current review of the NHS's pounds 44bn.

Mr Dobson was effectively slapped down by Tony Blair for fuelling the speculation. "We want to repair the NHS after years of Conservative damage, not undermine it," the Prime Minister said during a question-and-answer session with the public in Worcester.

Health experts said Mr Dobson had been put "between a rock and hard place" by the Treasury but coming after the rows over his warning that tobacco sponsorship of sport would be stopped, and attacks on bosses for producing "alcopops", questions were being asked around Whitehall about his long-term future.

Downing Street ordered an inquest into Mr Dobson's remarks and his appearance on BBC Radio's Today programme yesterday when he failed to scotch the reports. The British Medical Association echoed the general dismay by condemning the suggestion of new charges as "unfair and inefficient." A statement last night from Mr Dobson said: "Ideas floated by journalists today are simply scare stories."

However the Department of Health confirmed that patients on income support who have been in hospital over six weeks have two-thirds of their benefit deducted. State pensioners suffer a similar clawback of pounds 25 of their pension on the basis that they are not paying for food, heat and light while in hospital and it is the function of the NHS to care for the sick, not to cut housekeeping bills.

Some doctors argue that charges are necessary to restore equity between long-stay patients cared for in the NHS who are treated free and those who pay fees in nursing homes. Dr Douglas Newbury, consultant geriatrician at Ashford Hospital Middlesex, said: "Charging could help free up blocked beds which account for 15 per cent of all bed occupancy."

As Labour mounted a damage-limitation exercise, some senior ministers were highly critical of Mr Dobson, although he had adopted the Treasury line that nothing could ruled in, and nothing ruled out.