David Cameron was accused of breaking his promises on the NHS as he announced changes to the controversial package of reforms.

Shadow health secretary John Healey claimed the “massively mishandled” reorganisation would cost nearly £2bn of money which had been promised for patient care.

But in Commons exchanges health secretary Andrew Lansley insisted the government would oversee improvements in NHS care across the board.

The prime minister unveiled planned changes to the Health and Social Care Bill in a speech to NHS staff in London and set out five personal guarantees to patients in a bid to allay fears about the proposed shake-up.

In the Commons, Mr Healey told Mr Lansley: “The last year has been a catalogue of confusion, incompetence and broken promises.

“Will you now accept that the government’s massively mishandled NHS reorganisation is piling extra pressure on NHS services, with nearly £2bn promised for patient care being wasted on the internal changes?

“Will you admit it’s patients that will suffer as frontline NHS staff lose their jobs, treatments are cut back and waiting times start to rise again under the Tories?”

Mr Lansley said referral-to-treatment waiting times had fallen from 8.4 weeks in May last year to 7.9 weeks in the latest figures for March this year.

Outpatient waiting times had fallen from 4.3 weeks to 3.7 weeks, he added, telling Mr Healey: “So waiting times have improved.”

In a reference to reports of division within the Cabinet over the health reforms, Mr Healey noted the health secretary did not mention the five guarantees offered by Mr Cameron, adding: “Perhaps he wasn’t consulted about them.”

He continued: “People have seen the prime minister make and then break promises on the NHS before. This time he is breaking his pledges as he is making them.

“The King’s Fund say waiting times are going up, the Nuffield Trust say that health funding is being cut in real terms.

“And privatisation, the break-up of integrated care, and the removal of national standards at the heart of the health service are exactly what his health bill is designed to do.

“Isn’t this why MORI show that public concern in the NHS is rising rapidly and isn’t this why people are right to conclude they can’t trust the Tories on the NHS?”

Mr Lansley replied: “The prime minister has made it very clear that we are not going to let waiting times rise in the NHS and we are going to improve performance in the NHS right across the board.”

He said: “We are improving performance, driving down the number of breaches of the single-sex rules, increasing access to dentistry, cutting the number of managers, increasing the number of doctors.

“Those are the things we are doing in the NHS and it’s to the benefit of patients that we do.”