Just two days after being given the silent treatment by NHS union members, Patricia Hewitt returned to face heckles, slow handclaps and mocking laughter from 2,000 angry nurses.

The Health Secretary's speech to delegates at the Royal College of Nursing (RCN) in Bournemouth was drowned out by a chorus of chants, mostly calling for her resignation.

Undaunted, she battled on through her prepared speech pausing to sip from a glass of water as she waited for the shouts of "Resign" and "Shame" to die down.

Ms Hewitt trumpeted the Government's record on increased health spending. She said that the NHS provided the fairest healthcare system in the world. She said that more than £1 billion had been invested in service areas. She said that the NHS had to be realistic about the challenges it faces.

The Health Secretary's words did not soothe the restive crowd, further angered by news today of 450 job cuts in Norfolk and 60 new redundancies in Weston-super-Mare. More than 7,000 jobs have been axed in recent weeks as trusts struggle to balance their books despite a doubling in NHS spending.

"I know you’re angry about the possibility of redundancies among some hospital staff. Anybody facing the prospect of redundancy is entitled to feel that," she said.

As the audience began another round of slow handclapping, Ms Hewitt leaned forward on the lectern and peered over the top of her spectacles: "We can listen to each other or not - it’s entirely up to you. I would like to listen to you and I would like you to listen to me," she said.

There were cries of disbelief when the Health Secretary said that most nurses had just received substantial pay rises. She insisted: "The significant majority of staff got a pay rise. The pay rise over the last few years in the public sector has been significantly in advance of the private sector."

Ms Hewitt finally abandoned her speech, drowned out by shouts of “Enough, enough, enough” and “Point of order”, and instead took questions.

A bespectacled delegate took the microphone, and said: "You are a brave lady to come here after saying the NHS has had its best year yet". The woman's comment was greeted with huge applause.

Les Miles, 49, a neo-natal practice nurse at South Tyneside NHS Foundation Trust hospital, then asked the Health Secretary how his team was supposed to cope with one qualified staff nurse, one auxiliary nurse and 14 premature babies.

She replied, saying that she "absolutely acknowledged" what he was saying about understaffing, but she was drowned out by shouts of "don’t patronise."

Observers noted that there was a touch of the head mistress about Ms Hewitt when she surveyed the unruly audience and said: "I’m sorry if you don’t like the answers. But at least ... at least let me give them."

Ms Hewitt left the stage to general confusion and chants of "keep nurses working" as delegates stood and held up posters. One waved a good luck card, the words inside reading “In your new job?”

"Thank you, everybody," the chairman said. "I do think she will have got the message."

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