IN former times, defeat for the Labour leader at party conferences was commonplace. Asked what he was going to do after another conference bruising, Prime Minister Harold Wilson said he would get on with governing the country.

Tony Blair is less used to defeat, but must be tempted to adopt his predecessor's open defiance of the will of party delegates on the issue of foundation hospitals. He will be unwise to do so.

The suspicion about this particular health service reform is not just felt by a hard core of Labour activists, it is felt by a hard core of the British electorate.

Mr Blair must not ignore these legitimate concerns and carry on regardless.

For all its failings, the National Health Service and the people who work in it have the utmost respect of the public.

But that regard must not stand in the way of reform. A system created half a century ago must reflect the modern era of ever-expanding treatments and expectations. The NHS cannot stand still.

The founding principle of the NHS, that care should be free and available to everyone according to their need and not to their ability to pay, is as appropriate today as it was in 1945.

If foundation hospitals can be proved to be in accordance with that principle, then reform will be broadly accepted.

Despite its obsession with spin and presentation, the Government has failed to get across what foundation hospitals are about. It is this uncertainty which lies behind much of the public's and the Labour Party's apprehension.

Because of its lack of clarity, the Government has allowed the subject to be clouded by the issue of privatisation.

The first task facing ministers is to dismiss the notion of profiteering creeping into public services.

Then they need to tackle concerns over the possible creation of a 'two tier' service. The fear that, by creating a group of elite hospitals another group of failing hospitals will be left behind, is understandable.

Making standards of healthcare a lottery according to where you live is not a worthwhile reform.

The onus on the Government is to convince us that foundation hospitals will raise standards across the NHS.

If the level of service for all patients, no matter where they live, is to rise, then this is one reform the British public will embrace.

But the case has yet to be made.