Health secretary John Reid yesterday signalled that he would not back down in driving through reform in the NHS.

Promising to "maintain the momentum" he said that choice, coupled with the greater use of the private sector, was essential to delivering improvements in the health service.

Speaking at the NHS Confederation annual conference, Reid claimed that the NHS has still yet to achieve its goal of "equal access".

"In all of our decisions, plans, calculations or debates, all of us should recognise that the NHS must become even more of a personal health service, truly patient centred. The principles of the NHS is defined around the need of the patients, not the needs of the providers," he said.

And he conceded that the poor are still often let down by the health service.