Liam Fox will support Alan Milburn if he "keeps his nerve" on plans for NHS foundation hospitals.

In a bid to reopen Labour wounds on health service reform, Conservatives have pledged support for government proposals to reward the best performing hospitals with greater autonomy.

It is a move regarded by many - including former health secretary Frank Dobson - as heralding a two-tier NHS.

The shadow health secretary used an opposition day debate to offer his aid.

"Alan Milburn should keep his nerve and deliver foundation hospitals in face of criticism from his own party's MPs," Fox said.

"If Mr Milburn is courageous and sees the principle through without dilution he can count on Tory support - it is a direction that we are comfortable with."

The rare note of government and opposition frontbench unanimity aside, Dr Fox resumed service as usual.

"However, so far the secretary of state's plans smack of being made up as he goes along," he said.

"It is a panic response from a government that feels it has to produce reform."

Prodding Labour on an issue that has divided Number 10 and Number 11 Downing Street, Fox wondered how strong Milburn's commitment could be to a policy viewed with suspicion by Gordon Brown.

"The government is obviously divided over how much freedom hospitals should be given. The chancellor's attempts to slow down NHS modernisation is indicative of how deep their ideological divide on this issue is," he argued.

"When will the secretary of state outline exactly how far he plans to go with this policy and ensure patients are delivered the quality of healthcare they deserve?"

Liberal Democrats also highlighted government divisions on the NHS reform.

The party's health spokesman, Dr Evan Harris, branded Milburn as "muddled and inconsistent".

"In trying to please the right wing free marketeers in 10 Downing Street, at the same time as appeasing Labour rebels loyal to 11 Downing Street, he is trying to have it both ways and ending up satisfying no-one," he told the Commons.

"The fundamental problem is that foundation hospitals are not truly free or locally accountable, and to the extent that they have flexibility they are divisive.

"It's a flawed proposal inadequately defended by a rattled and increasingly desperate secretary of state."

Defending the plans, the health secretary insisted they would help to spread best practice throughout the NHS.

Milburn told MPs that the Conservative aim was to run down the health service and push the public into paying for private health insurance.

"Their programme is cutback and closure. Labour's programme is investment plus reform. It is this programme which will deliver improvement in the NHS," he said.

And Milburn pledged that the trusts would "usher in a new era of public ownership where it is local communities that control and own their local hospitals".

"They will be bound by a statutory duty of partnership, to work in concert with other local NHS organisations," he added.

As MPs debated healthcare in the Commons, NHS organisations urged the government to ensure that would-be foundation hospitals developed strong links with local primary care trusts.

"Most healthcare is delivered across organisational boundaries, and hospitals increasingly need to work as part of these wider networks. Strong relationships between individual hospitals and their PCTs must therefore be a key test for those wanting to be foundation trusts," said Nigel Edwards of the NHS Confederation.

Submitting its written evidence to the health select committee's inquiry into foundation hospitals, the confederation called on the government to explain its plans with greater clarity.

The organisation called for "further work to ensure that the new governance arrangements actually deliver real local ownership, and further details about the additional pay freedoms that will be made available".

"We need to ensure that there is a more radical package of deregulatory reform for all trusts if we're to unleash innovation across the service. Rewarding high performers must also be accompanied by more effective work to help struggling organisations, if all patients are to benefit from higher standards of care," cautioned Edwards.