Shadow health secretary Andy Burnham accused prime minister David Cameron of a u-turn on NHS policy in his speech to the Labour party conference today.

Mr Burnham, who will find out if he keeps his post in the next two weeks, said Mr Cameron had abandoned his commitment to protect the NHS.

Before the ink was dry on the coalition agreement which promised no more reorganisation we get the biggest ever, what changed?

He said the government’s reforms would “rip apart” the NHS by fragmenting it, marketising and undermining Labour’s improvements in standards, particularly waiting times.

Mr Burnham said: “Before the election Mr Cameron said his priorities could be [summed] up in three letters, NHS. My message to the prime minister is you said you were a friend of the NHS one day, and rip it to pieces the next. People will never forgive you for it.”

He asked: “Before the ink was dry on the coalition agreement which promised no more reorganisation we get the biggest ever, what changed?”

Mr Burnham, who is understood to want to keep the health brief, said members should put up “the fight of our lives”.

The Parliamentary Labour Party elects members of the shadow cabinet but it will be down to Ed Miliband, as leader of the party, to assign specific portfolios, subject to a female quota of a third.

Mr Burnham is expected to retain a senior shadow cabinet role – not least because he is viewed as a member of the Blairite wing of the party and the Brownite Mr Miliband will need to award a fair distribution of roles if he hopes to unify his party.

However in Manchester this week other senior names were being attached to the health portfolio role. These included the deputy leader of the party Harriet Harman and Ed Balls.

Mr Balls ran alongside Mr Miliband and Mr Burnham in the party leadership contest, in which he came third – one ahead of Mr Burnham.

Although Mr Balls is also tipped for the shadow chancellor role there has been speculation his wife Yvette Cooper could beat him to that prized position.

The shadow health brief is seen as one of the priority positions on the Labour front bench as Mr Miliband’s team view health secretary Andrew Lansley is a “weak link” in coalition government.

Several MPs with previous health minister experience – including Caroline Flint, Ivan Lewis, Ben Bradshaw and former health secretary Alan Johnson – may have marked their cards by voting only for their new leader’s brother, David Miliband, in the leadership election. Thirty four Labour MPs – including many former ministers – did the same.

Mr Burnham, by contrast, was the only one of the five leadership candidates who used all five of his votes in the contest. He voted for himself first, David Miliband second and Ed Miliband third.

Ed Miliband’s advisory team includes Greg Beales, who was health advisor to the former prime minister Gordon Brown before the election in May.