Prime minister Tony Blair has given his backing to Labour MPs who oppose hospital closure, despite telling NHS managers that he instructed Labour politicians to give their backing to changes in local services.

During prime minister's questions last week, Mr Blair defended the right of ministers to take part in local protests against NHS reform. He said they were 'perfectly entitled' to protest against local decisions.

Challenged by Conservative MP Mark Francois, who accused Mr Blair of allowing home secretary John Reid and Labour Party chair Hazel Blears to 'rebel over NHS cuts in defiance of your own health policy', Mr Blair replied: 'MPs who are ministers are perfectly entitled to take part in local consultations.'

This message appears to run contrary to comments made by Mr Blair to a group of NHS managers in December: 'If we are not prepared to back people making these difficult changes then two things will happen: first of all they will say that they can't make them, in which case we actually let patients down in the name of protecting patients; but secondly, we will get to a stage two or three years down the line when we face the electorate again when people will say well for all the investment that has gone in, is this really 21st century care you are giving us?'