On Wednesday night John Major repudiated health department instructions forbidding reporters to accompany John Smith, the Labour leader, on a visit to Bart's accident and emergency unit, threatened with closure.
At Question Time yesterday, the two men clashed over the visit with the Prime Minister accusing Mr Smith of turning the NHS into a 'political football'. But their rhetoric was fairly restrained compared to that of Mrs Bottomley as she responded to a Labour debate on health services in London. Mr Dobson is his party's spokesman on London as well as transport, but Mrs Bottomley chose to ignore this. It was an 'insult' to Londoners and their health service that he should open the debate, she said. 'Instead of a bona fide health spokesman from Labour, we get a performing political monkey.' Mr Dobson was 'devoid of understanding', a ranter, a peddler of 'sound-bite cynicism'.
David Blunkett, Labour's health spokesman, had been 'binned' in order to give Mr Dobson 'a bit of pre-election Lebensraum', she said. 'We know, however, what Labour are up to. They aren't interested in a debate about health. All they want to do is boost their miserable campaign for the London elections.' That was why Mr Dobson had opened the debate. 'He is, after all, their campaign cheerleader - a job he got as a consolation prize for coming second to John Prescott in a beauty contest.'
The rest of Mrs Bottomley's speech - lasting 55 minutes compared to the 22-minute estimate on the text - was a testy defence of her plans to reshape health services in the capital. Hospitals and units regarded as surplus will close and more emphasis be given to primary care, particularly by GPs. 'I give an absolute commitment that services in London will only change for the better,' she told MPs.
Goaded by Bart's campaigner Brian Sedgemore, Labour MP for Hackney South and Shoreditch, about her degree in sociology, Mrs Bott omley snapped back that she had two of them. 'It is because I have two degrees in sociology that I believe that the way forward is to assess the local health need, not to be dominated by institutions, respected and loved though they have been.'
Mr Dobson's point was that Bart's is still loved. He bid the Secretary of State 'ponder whether she, who hasn't held her office for 800 days, should wipe out a hospital that has served Londoners well for 800 years'.
Deploring the growth in bureaucracy, billing and debt collecting in the NHS, Mr Dobson said that in the four Thames regions while the number of nurses had been reduced by 5,000, the number of management staff had risen by 5,700. Hundreds of millions had been spent on consultants and lobbyists - 'a whole rag bag of Porsche drivers receiving outdoor relief at the expense of the patients'.
A real conservative would not go for change unless the benefits would clearly exceed the bother and expense involved, he added. 'The Government's approach to the NHS, with its endless changes, owes more to the theories of Trotsky on the Permanent Revolution or Chairman Mao on the Cultural Revolution than ever it does to Edmund Burke or Adam Smith.'
In a noisy Question Time bout, John Smith said now Mr Major had overruled his health secretary over media access to Bart's he should overrule her on the far more important issue of her 'disgraceful decision' to order the closure of its accident and emergency unit.
'Government plans for London are that 19 hospitals are either to close or be merged and 2,500 desperately needed hospital beds are to be lost. Why does not the Prime Minister halt this disaster for health care in London, order an immediate moratorium and a review which all of London wants?'
Mr Major said it sounded very much as if the Labour leader was in the business of spending 'vast sums' of extra money. He should be 'more concerned with the realities of health care in London and less concerned with party politicking at the expense of the NHS'.
There had never been any question but that Mr Smith or any other MP could visit Bart's or any other hospital, he insisted.
'The point is that what he wished to do was to do what he has done on so many occasions in the past and take the opportunity of turning the NHS into a political football.'
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