Labour 'must accept that NHS market exists'

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LABOUR must drop its opposition to competition in the National Health Service and accept it cannot 'turn back the clock' on the Government's new market-led system, David Blunkett, the party's health spokesman, told colleagues yesterday.

The party should focus on integrating self-governing trusts and general practitioner fundholders into a more coherent health service 'rather than pretend we can abolish what is already there', he said.

He predicted the present two- tier service, that enables patients of GP fundholders to jump queues for hospital treatment, would become more explicit over the next few years, leading to the end of fundholding. The method for distributing money to fundholders was so crude that some were being overpaid by as much as pounds 200,000 a year, while others were running out of cash. Even if all GPs switched to the new arrangements, the fundamental inequalities of the funding system would remain, he said.

In a speech to the Parliamentary Labour Party, Mr Blunkett argued that the need to improve public accountability and democracy in the NHS must guide policy-making on health in the run- up to the next election.

Mr Blunkett maintained the Government had acknowledged the weaknesses of untrammelled competition by resisting the demands of many trusts to scrap regional health authorities.

Mr Blunket indicated that Labour would go with the grain of present Government policy to make a gradual shift of resources away from the hospital provision towards primary and community health service.

Labour has already given broad support to the conclusions of the Tomlinson inquiry on London health services that there are too many acute hospital beds in the capital.

In its forthcoming discussion document, Health and Wealth of the Nation, Labour also planned to raise the profile of health promotion, and the links between unemployment and poverty and health.