The health secretary has sought to confront critics of the government with a speech arguing the case for foundation hospitals.

John Reid said on Wednesday that far from creating a two-tier health service as his opponents suggest, foundation hospitals will extend equality throughout the NHS.

Speaking to a meeting of the Amicus trade union, Reid took the attack to the policy's critics by claiming they were opposing their own objectives.

Ahead of his party's annual conference this month, where foundation trusts are likely to come in for heavy criticism, he claimed the initiative was designed to empower the disadvantaged.

Critics claim the rewarding of the best performing hospitals with foundation status - allowing them to raise their own revenue and freeing them from Whitehall control - will create a two tier NHS that would benefit articulate, middle class members of the public.

But Reid insisted the reverse was true and that the present structure of the NHS had failed to provide an equal service.

He also responded to a claim from a group of think tanks that Labour had run out of ideas aimed at tackling inequality.

"If we were not addressing the issue of equity, then think tanks could rightly claim we had lost our way. But we have not," he said.

"It is by developing choice and capacity in the NHS that Labour will increase equity in health in his country.

"This is not a hunker in the bunker policy. It is a real challenge to those who mistake the structures of the NHS for its values".

Under the present system of "NHS mass production", "people with more information, confidence and general knowledge of public services are in a better position than others," Reid claimed.

"The existing system, in fact, distributes access unequally," he went on.

"Almost 60 years of telling people what to do and where to go has not created equality of access.

"Each hospital on offer will be backed by detailed information, which will be on hand in the GP's surgery.

"It will mean that people will be able to make decisions that fit into their own lives and their own calendars. Not just those who know a hospital consultant but everybody for every referral."

Reid said that opponents should not be blind to the reality of the situation.

"We start from a position that recognises a painful truth: 55 years of a 'uniform service' has not created equality of access," he said.

"If we believe in greater equality of access, we need to empower not just the few but the many.

"To do this, we need to put the information and support in the hands of every patient and encourage them to take a greater say in where they have their treatment."