Health service managers have slammed the quality of patient care in their own hospitals. More than 37 per cent of those who voted at the NHS Confederation conference said their own experience as patients was 'poor' or 'very poor'.

Just 11 per cent said they, or their families and friends, rated care as 'excellent', while 20 per cent said it was 'good'.

The delegates who voted were overwhelmingly hospital managers or staff - a vote at the start of the conference found that more than 55 per cent were from trusts.

Fewer than 10 per cent were from primary care and only 16 per cent from health authorities or boards.

NHS Confederation policy director Nigel Edwards blamed 'constant pressure' to reduce costs and meet government-defined indicators.

'One of the problems with the way accountability works is we have perhaps not paid enough attention to some of the basics about the patient experience.'

Dr Martyn Wake, co-chair of the executive committee at Nelson and West primary care group, said systems just didn't work.

Patients in his area who had suffered a stroke had to wait 12 weeks to see a specialist.