Mr Blair said patient care was improving

Tory leader David Cameron said an MPs' report said many financial problems were due to constantly changing priorities and poor central management.

He said the prime minister was a "lame duck" and the government could not address the problems until he resigned.

But Mr Blair replied that after years of cutbacks under the Tories the NHS was getting better under Labour.

The Commons health select committee reported on Wednesday that mismanagement at all levels of the NHS in England had led to a multimillion pound deficit - last year it stood at �547m.

Care 'harmed'

The committee said local financial mismanagement was a factor - but found existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets.

During Prime Ministers' Questions, Mr Cameron told MPs: "The prime minister stands here week after week saying that local cuts are the fault of local health staff, but this report shows it is poor central management."

Isn't the problem that the government can't address the problems of failure at the centre because the person at the centre is a lame duck? David Cameron

He challenged the prime minister to say patient care was being harmed, adding A&E departments were under threat, maternity units under review and community hospitals closing.

"The prime minister must be the only person in this country who thinks patient care isn't suffering," he said.

"Isn't the problem that the government can't address the problems of failure at the centre because the person at the centre is a lame duck?," Mr Cameron said.

A&E 'transformed'

But Mr Blair said the report had also reported improvements in the health care system and added that for the first time average waiting times for outpatients' appointments were below four weeks.

"I believe that patient care is improving in this country," he said.

"When we came to office there were literally hundreds of thousands of people that used to wait 12 months, or 18 months for their operations. We are now on course for an 18-week door-to-door, that's in and outpatients combined."

He said A&E departments had been "transformed", and hailed improvements in cancer and cardiac care, waiting times for cataracts operations and the NHS's biggest hospital building programme.

Mr Blair added: "The NHS is getting better. It's getting better under a Labour government and after years of cutbacks and underinvestment under the Tories, for the first time the NHS is yet again the pride of the country."