The health secretary has told the Labour conference that he is determined to press ahead with his overhaul of NHS structures.

Following Tony Blair's pledge to make the health service more patient-focused, Alan Milburn told party activists that controversial reforms are needed to ensure that services meet public expectations.

Milburn is pressing ahead with plans to give the most successful "foundation hospitals" more freedom from central NHS control - despite criticism that it could lead to a two-tier health service.

Milburn attempted to soothe fears - arguing that the reform plans are rooted in the best traditions of the NHS, delivering healthcare free at the point of use and on the basis of clinical need.

He also pointed to record funding increases as proof of the government's commitment to a publicly-funded health service.

The health secretary told the conferencne that reforms would help the NHS respond to the wishes of patients.

"Rather than the hospitals choosing the patients, we've got to have patients choosing the hospitals," he said during a question and answer session with delegates.

"In the end, if we are going to have, genuinely, a health service that puts patients first, patients are going to have to have more power and more choice."

The health secretary is also locked in a Whitehall battle with chancellor Gordon Brown over whether foundation hospitals.

He believes that they should have the freedom to borrow on the money markets in order to develop their services.

The Treasury has expressed concern that such a move could push up government debt and see hospitals borrowing in order to pay higher wages to attract staff from neighbouring hospitals.

But Milburn argued that his reforms are essential to ensure the NHS delivers more patient choice, better healthcare and devolves power to frontline staff.