Alan Milburn, the Secretary of State for Health, blamed growing queues in hospital accident and emergency departments on poor management standards while anger grew over a damning Audit Commission report that found waiting times in A&E units were longer than five years ago and likely to get worse.

Critics accused the Government of fuelling the problems by failing to invest more heavily in the NHS, strangling the service with red tape and closing care-home beds.

Mr Milburn, who has announced another £40m to create an extra 600 A&E nursing posts, admitted the commission's findings were disappointing, but denied the cause was a shortage of money or staff. "The problem is primarily one of organisation in the A&E department and management in the hospital and that is what we have got to get put right. One of the things we have got to do is to relieve the pressure on the A&E department by relieving the pressure on the hospital as a whole," he said.

But the Liberal Democrats' health spokesman, Evan Harris, said the Government and not hospital management was at fault. "The Alan Milburn strategy seems to be to blame managers and staff for not working hard enough or failing to embrace so-called reforms,' he said. "But it is the Government's own failure to invest... that is causing the problem."

Liam Fox, the shadow Health Secretary, described the report as a "damning indictment of Labour's handling of the NHS," after spending the night in a London A&E unit. "The sad thing is how frustrated they felt that, no matter how hard they worked, they couldn't deliver the quality of care they felt they should. They complained that they were totally snowed under with paperwork and red tape," he said, adding that the problems in A&E reflected the fact that 50,000 care-home beds had been since Labour won power in 1997.

Dr Peter Hawker, chairman of the British Medical Association's consultants committee, said: "A&E departments over many years have been understaffed and inadequately resourced." He conceded that hospitals now had more doctors but there was still a shortage.

The head of nursing at Unison, Karen Jennings, said: "Employing more nurse practitioners in A&E would make an important contribution to cutting waiting times and freeing up doctors to deal with the most serious cases. There are solutions which require investment and resources in the NHS and it is crucial the evidence of good practice is systematically shared."