David Cameron admitted yesterday that the Government had failed to explain its NHS reforms well enough but ruled out further concessions to the growing number of critics of its plans.
The Government suffered a double dose of trouble as Andrew Lansley, the Health Secretary, was heckled by a 75-year-old woman as he arrived at Downing Street for a meeting with health professionals. And David Cameron was accused of a "bunker mentality" after groups representing health staff who oppose the reforms were excluded from the talks.
In an exchange captured by TV crews, June Hautot, a former NHS union representative, accused the Health Secretary of lying over the Government's intentions.
Later the Health Secretary played down the incident as "sticks and stones", saying: "The only thing that matters to me is that patients in the NHS get the best possible service and really feel that they share in decisions about their care."
Groups excluded from the hour-long No 10 meeting included the Royal College of General Practitioners, a move which raised eyebrows since GPs will gain the most power from the reforms.
Clare Gerada, the college's chairman, said she was "puzzled" by its exclusion. "I'm also a little bit worried that what's happening is they're shooting the messenger, rather than listening to the messages that we're bringing on behalf of patients, GPs and nurses who are very, very worried about this Health Bill." She dismissed claims by ministers that it was too late to amend the reforms.
Downing Street insisted that no one had been excluded from talks about how the changes were being implemented, and that yesterday's session was only one in a series of meetings.
The Prime Minister told the meeting that the changes were about "evolution not revolution". He said afterwards: "We had a constructive and helpful meeting and there are quite a few myths that we need to bust about this reform. Choice for patients is a good thing: making sure that doctors and nurses, not bureaucrats, are making decisions – that's a good thing."
In a BBC interview, Mr Cameron stressed he was committed to the shake-up but conceded: "We need to do everything we can to explain to people this is about improving and enhancing our NHS, not in any way endangering it".