THE biggest opponents of foundation hospitals have come from within the Labour Party itself, led by former Health Secretary Frank Dobson.

Their major concern is that to invite the best performing hospitals to apply for the special status is akin to creating a 'two-tier' health service. Fine for the people who live in an area where a foundation hospital exists but for the others...

A rebellion of Labour MPs was expected to go into three figures in the Commons on Wednesday, but when Alan Milburn announced ALL hospitals will get foundation status by 2007 or 2008, it appeased some and only around 60 MPs voted against the Government.

Locally, the most vociferous opponent was Pendle MP Gordon Prentice. He said: "It will create a two-tier NHS and was not in the manifesto. There is strong opposition within the Parliamentary Labour Party which cannot be dismissed."

Unions too are less than enamoured of the proposals.

TUC General Secretary-elect Brendan Barber said: "The health unions support the development of a more flexible, responsive and innovative National Health Service that can deliver ever higher standards of care to meet the needs of patients.

"But unions have not been convinced that foundation hospitals will deliver the improvements we all want to see. Instead these proposals have provoked powerful fears that a coherent NHS will be undermined by the injection of more market processes that will exacerbate rather than diminish inequalities in health provision."

The idea that the new foundation hospital boards would be directly elected by trustees who would pay a subscription has also fallen foul of some local authorities.

Sir Jeremy Beecham, the chairman of the Local Government Association, rubbished claims that the new hospitals would represent a chance to devolve power to the local level.

Instead, he claimed that plans to directly elect the governors of the foundation trusts would make it harder for local authorities to work with the NHS.