Short under new threat for failing to back health Bill

Clare Short was in fresh trouble yesterday after she failed to support the Government's flagship scheme to set up foundation hospitals.

The International Development Secretary angered some ministers by missing Wednesday's crucial vote on the Health and Social Care Bill. Ministers had been ordered to attend to combat a backbench rebellion.

Ms Short apologised to Downing Street, saying she had believed the Commons vote would take place at 10pm rather than 7pm, the normal time for votes on a Wednesday under the parliamentary hours introduced in January. She said she left her department for the Commons at about 8pm but then heard that the vote had already happened. A spokeswoman for Ms Short said: "Clare missed the vote due to a mistake."

Allies insisted she did not abstain and was intending to vote in favour of the Bill. But her absence raised eyebrows at No 10, with one minister describing her explanation as "a bit odd".

Ms Short's position in the Cabinet was already under threat for branding Tony Blair's strategy on Iraq as "reckless". There is speculation she may resign or be sacked when Mr Blair reshuffles his ministerial team. She missed the weekly cabinet meeting yesterday because she was preparing for talks with the presidents of Uganda and Rwanda.

Despite being approved in principle by the Commons, the Government's plans for foundation hospitals face defeat in the House of Lords. Tory and Liberal Democrat peers have agreed privately to join forces when the Bill goes to the Lords this summer after completing its passage through the Commons. The Tories have 213 peers and the Liberal Democrats 65, enough to outgun Labour's 186 peers. There are 179 independent crossbenchers.

The looming rebellion could force Alan Milburn, the Health Secretary, to make further concessions over his plans to give more freedom to high-performing hospitals.

If the Bill is defeated in the Lords, Mr Milburn will ask MPs to overturn the decision when the measure is sent back to the Commons. But opposition in the Lords could embolden Labour MPs who oppose foundation hospitals and swell the ranks of rebels, 63 of whom voted against the Government on Wednesday. Up to 50 other Labour MPs abstained. It was the largest rebellion by members of a governing party in a second reading debate since 1986, when 72 Tory MPs helped to defeat the Bill to allow shops to open on Sundays.

The Heath and Social Care Bill is already behind schedule after being delayed by the Government, which did not want to face a rebellion by Labour MPs during the Iraq war. A running battle with the Lords could delay its passage further and increase the pressure on ministers to make further changes.

Labour MPs said yesterday that they would continue to oppose the Bill . They will table further amendments at the committee and report stages designed to prevent foundation hospitals resulting in a two-tier National Health Service.

Glenda Jackson, a former minister, said: "I have little doubt that ... there will still be a continuing effort on the part of those who don't wish to see the basic principles of the NHS destroyed." David Hinchliffe, Labour chairman of the Commons Health Select Committee, warned: "The concerns expressed by many Labour MPs will not go away."

John Reid, the Leader of the Commons, dismissed the rebels as a small minority and said most MPs were pleased that the Government could press on with reform.