The Health Secretary, Alan Milburn, warned doctors and nurses yesterday that an extra £660m for the NHS in the Budget meant there were no longer excuses for failing to deliver better services for patients.

"What patients want to see in every part of the country is excellence not excuses," Mr Milburn told MPs. Announcing details of the £60m "bonus fund" for primary care groups of GPs who meet the Government's targets, Mr Milburn said: "The new challenge for the health service is to use that money to good effect and start to make a difference patients can see."

Mr Milburn defended himself against allegations he was taking more central control over the allocation of resources.

Stephen Thornton, chairman of the NHS Confederation, also insisted health authorities were not being bypassed. He blamed spin-doctors who had damaged the NHS partnership between Government, doctors and nurses by suggesting that health teams were under attack for failures. "He [Mr Milburn] doesn't need to talk so tough. What he needs to do is talk the language of partnership," Mr Thornton said.

Some of the bonus fund will go to family doctors who offer more flexible surgery hours to meet patients' demands. The fund is part of a strategy to force health authorities to meet the Government's promises on the health service. Flexible opening times for GP surgeries to meet the lifestyle of working families is another of the Government's priorities.

Mr Milburn has written to health authorities directing them to allocate the bonus fund to primary care groups that are meeting the Government's priorities, which also include reducing waiting lists, tackling winter pressures and providing care homes for the elderly to stop them blocking up hospital beds after treatment.

"We are not being prescriptive," a ministerial source said. The bonus fund will be added to the extra £600m in the Budget for the NHS from 1 April.

Trusts and primary care groups that miss the targets will be given warnings before management teams are sent in.