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 that 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. Mr Lansley said: "We are not privatising the NHS." She replied: "I've got news for you. You've been privatising it since 1979." She also told Mr Lansley: "I've had enough of you and of Cameron."
Later the Health Secretary played down the incident as "sticks and stones", saying: "The only thing that matters to me is that I get to a place where the 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, 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, nurses and a whole host of people who are very, very worried about this health Bill."
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.
Those who did attend included the National Association of Primary Care, representing thousands of GPs; Lord Ara Darzi, the former Labour Health minister; the Royal College of Surgeons, Royal College of Physicians, Royal College of Anaesthetists, Royal College of Paediatrics and Child Health, Royal College of Obstetrics and Gynaecology, the patient umbrella group National Voices, the Foundation Trust Network, the NHS Confederation and the NHS Alliance.
Some groups did raise concerns about the introduction of more competition in the NHS and about the strong opposition from other organisations, including the British Medical Association and the Royal College of GPs.
The Prime Minister told the meeting that the changes were about "evolution not revolution" and agreed with the NHS Confederation that the focus needs to move from the theory of the reforms to the reality of implementation. He said: "We had a constructive meeting and what's clear is that there are quite a few myths that we need to bust. 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."
Ed Miliband, the Labour leader, said: "This bunker mentality is the wrong way to run the NHS. It's not too late to start listening to the doctors, the nurses and the midwives. It's not too late to listen to patients."