Tony Blair's admission that the government should be "absolutely frank" about the time needed to improve the NHS was thrown back in his face yesterday when a senior surgeon accused him of raising unrealistic expectations by "spinning" the figures. Bernard Rebeiro, a consultant surgeon at Basildon hospital and member of the council of the Royal College of Surgeons, told the prime minister that by promising 7,500 new consultants, when only 1,500 of these would be new posts, or 200 new CT scanners, when all but 50 were replacements, "the government is giving the impression the health service is going to be so much better when it isn't".
He added: "One of the big problems you have here is one of expectation. I am very concerned that we need to be very frank with the public and make sure they do know what they are going to get."
The former president of the Association of Surgeons of Britain and Ireland called for an end to such "spin, double accounting and treble accounting" as Mr Blair faced the Royal College of Surgeons for the first time since the publication of the NHS Plan in July.
Doctors' leaders had been infuriated by the £19.4bn blueprint for reform's proposal to ban consultants from practising in the private sector for seven years - a move described by the BMA as "an ill-conceived, vindictive attack" - but yesterday surgeons privately decided not to grill Mr Blair on the issue.
"We are all still very concerned about it because it takes away our freedom to do what we want in our spare time but we didn't want to get sidetracked when the real issue is advising on how to deliver the right health care for the NHS," said Mr Rebeiro.
In return, the prime minister appeared placatory, stressing that the government wanted the ban so that young consultants concentrated on building their expertise within the NHS, but acknowledging the need for further discussions. "Try and understand what we're trying to deal with so we come to an arrangement that suits you and us for the long term," he added.
He urged surgeons to embrace the plans for modernisation, warning that without their support the NHS could not offer the health care needed. "In return for the money, some of the old style practices, old style demarcations between professions, uncollaborative ways of working must go," he warned. "The NHS ... needs to become better. To adapt. To be prepared to do things differently."
But he also admitted the government had misjudged the depth and scale of the problems afflicting the NHS. "I know our first two years in office were very tight, and I am sorry for that," he added.
He stressed the need to be "absolutely frank" about the time needed to improve the NHS - a pledge reiterated by the health secretary, Alan Milburn, who said the government would gain more respect by being "dead straight with people about the depth of problems and the amount of time to put it right".
Speaking after such pledges, Mr Rebeiro reiterated that the government would face fierce criticism if it failed to deliver - and challenged ministers, in their accounting, to show such honesty.
