Clarke backs Bottomley's caution over NHS

KENNETH CLARKE, the Home Secretary, is supporting Virginia Bottomley, the Secretary of State for Health, in her attempts to proceed cautiously over further changes to the NHS.

Mrs Bottomley will today announce a compromise over the Tomlinson report on the closure or merger of leading London teaching hospitals, opening her to renewed attack by some right-wing Tories, who believe it is a retreat from the radical surgery that was needed in the capital's health care.

The Secretary of State for Health is also accused by the right wing of going soft on the changes to the NHS for proposing a compromise over the abolition of the regional health authorities.

The right accuse the regions of too much interference in the operation of the trust hospitals, which have opted out of health authority control, and want the regions swept away.

That view was opposed in a Cabinet committee on the future of the regions by Mrs Bottomley, who warned Cabinet colleagues that the NHS internal market could not be allowed to become a 'free-for-all'. She is proposing to retain the regions in a slimmed-down form to prevent the risk of patients being denied treatment as hospitals close under the force of the market.

Following reports that Mr Clarke, a former Secretary of State for Health, was undermining her stand, the Home Secretary is understood to have written to Mrs Bottomley to reassure her that he supports her view. The Cabinet struggle over right- wing ideas will be echoed on Thursday by a lunch-time seminar by the Adam Smith Institute, a right-wing think tank, covering workfare, toll roads, road pricing, rail privatisation, Post Office privatisation, and opt-outs from state pensions.

The institute, run by Madsen Pirie, one of the Prime Minister's panel of advisers on the Citizen's Charter, has been encouraged to press ahead with radical policies by the Government's announcement of a wide- ranging review of spending on social security, law and order, health and education.