Doctors in Spain - where foundation hospitals were established four years ago - say the system is bureaucratic, expensive and inefficient.

Our Foundation Hospitals will not be exactly the same as those in Spain

Department of Health spokesman

In a paper obtained by the British Medical Association magazine BMA News, they said foundation hospitals had experienced "multiple problems".

The government is hoping to establish Britain's first foundation hospitals next year.

The not-for-profit trusts would be able to set their own clinical and financial priorities for the first time without interference from Whitehall.

Higher standards

The government believes foundation hospitals will help to drive up standards across the NHS.

Health Secretary Alan Milburn announced his plans to establish foundation trusts after visiting a similar hospital in Madrid last year.

But doctors at one such hospital in Segovia said foundation hospitals in Spain had fewer staff, less beds and received more complaints from patients.

They added that some foundation hospitals cherry pick patients with less complicated conditions to boost their results.

In their report, they said: "Foundation hospitals do not run smoothly."

They added: "It is surprising to us, health professionals in Spain, that this model of public hospital management could become established in the United Kingdom."

'Critical analysis needed'

The Spanish doctors advised the government to reconsider their plans.

"The new paradigm of evidence-based medicine should prompt the leaders of the NHS to do some critical analysis before introducing a formula that, at least in Spain, has created so many problems," they said.

Proposals to turn more public hospitals in Spain into foundation hospitals have been widely opposed.

One of Spain's 17 autonomous health regions, the Balearic Islands, is considering returning its two foundation hospitals to public hospital status.

The Department of Health said that NHS foundation hospitals would be different to those established in Spain.

A spokesman said: "Our foundation hospitals will not be exactly the same as those in Spain.

"It might be sensible to wait and see what our detailed proposals will be before making accusations like this."