Patients are to be given a say for the first time in bonus awards made to successful hospitals and family doctors by the Government.

Alan Milburn, the Secretary of State for Health, is working on plans to engage "patient power" to decide on the most successful doctors who deserve extra resources from the Budget. "We are going to be asking a number of patients' organisations to work on these groups for modernisation action teams. We are going to have a number of patients' representatives and we will be looking at how we can get patients' views better reflected in the rewards to doctors," Mr Milburn said.

It follows a second national NHS survey of patients, which shows that the delivery of care has unacceptable regional variations in standards. The modernisation action teams will use the views of patients before recommending cash increases for health teams, which are proving successful.

Mr Milburn made clear that patients' complaints would also be taken into account but he said it would not mean hospitals or primary care groups (PCGs) losing money. The aim would be to raise the standards to the best in the NHS, with more Budget cash from the £15bn extra for the NHS.

Mr Milburn is ready to intervene by putting new management teams into hospitals or PCGs judged to be failing to meet the Government's targets. A bonus award of £60m will be directed to PCGs preparing for next winter's pressures, reducing waiting lists and reducing "bed blocking" by providing beds for the elderly in care homes, out of hospitals. The Secretary of State for Health was speaking to The Independent after a Downing Street seminar chaired by the Prime Minister with senior health professionals, including nurses and GPs, to discuss plans for raising standards of health care across the country.

The Prime Minister's official spokesman said Mr Blair had been encouraged. "There is a huge appetite for change and reform," he said. Sue Jennings, a nurse from Basildon Hospital, Essex, briefed Mr Blair on a clinic booking system, which has slashed the number of patient appointments where the patients do not turn up, and is to be adopted nationally.

Dr John Oldham, a Manchester GP heading a PCG modernisation team, told of a Torbay GP who is using equipment to monitor heart patients and has reduced the numbergoing to hospital. Out of 166 heart patients, only 16 had to be referred to hospital.