Patients with long-term illnesses look set to be given personal budgets, allowing them greater choice over how they are treated, Gordon Brown suggested yesterday.

The Prime Minister used a speech to mark the start of the NHS’s 60th anniversary to give the broadest hint yet that he wants more choice in the NHS with individual allowances, currently available only for social care for the disabled and elderly.

He also called for an overhaul of food labelling, urging manufacturers to agree on one system easily understood by consumers, to combat obesity.

But the speech was overshadowed by the admission by Alan Johnson, the Health Secretary, that only a fraction of hospitals had been given a deep clean. Speaking on the BBC, he said: “As far as I am aware the process is well under way. We expected every hospital to have carried out the deep clean by the end of March. Roughly we are into the first 50 that have been under way so far.” The Department of Health later said that the figure referred to the 170 hospital trusts in England, not the 1,500 hospitals.

Mr Brown told health professionals at King’s College London that 100,000 people with long-term conditions should now be given the ability to manage their care themselves and 15 million patients with chronic or long-term conditions should have access to care at home. Doctors should monitor conditions using the internet and telephone, checking on patients’ blood pressure and weight remotely, he said. “During 2008 we will bring forward a patient’s prospectus that sets out how we will extend to all 15 million patients with a chronic or long-term condition access to a choice . . . Real control and power for patients, supported by clinicians and carers. And where it is appropriate, just as with personal care budgets for the 1.5 million social care users, it could include the offer of a personal health budget.”

He said that 150 private hospitals will work with the NHS from the spring, and promised greater use of the voluntary sector to promote competition but he insisted that patients must show responsibility too, saying that those who did not turn up for appointments would not be entitled to the 18-week waiting-time limit from GP referral to treatment.

Lord Darzi of Denham, the surgeon and Health Minister, said that the care of patients with serious injuries should be centralised in specialist centres. He told peers: “Studies indicate three to four thousand cases of severe trauma each year in the UK. The majority of hospitals sees less than one severely injured patient per week. However, evidence does suggest that seeing more cases leads to better outcomes.

“It is the one area where we have clear evidence that centralisation of services to have the adequate competencies at these hospitals will significantly impact the quality of care.”

Niall Dixon, the chief executive of the King’s Fund, the independent health think-tank, said of plans to offer health screenings to every citizen: “The important point is that screening has to be cost-effective. It is vital that screening is targeted at those groups at highest risk.”

Andrew Lansley, the Shadow Health Secretary, said: “There is no proper timetable for delivery, we don’t know where the money’s coming from, but we do know Brown has raided public health budgets. And the Prime Minister is pledging things that haven’t been recommended by his own advisory group on screening.”

Nick Clegg, the Lib Dem leader, said: “Gordon Brown is ducking the fundamental issue of overall reform of the health service. No one can argue against a greater focus on prevention but this smacks of tinkering.”

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