Health secretary Andrew Lansley has met with a hostile reception at a conference of angry nurses.
The Royal College of Nursing's (RCN) annual conference saw Mr Lansley face a barrage of hostile questions after he delivered a speech met with tepid applause - in contrast with the wild cheers which greeted questions attacking the "theft" of nurses' pensions and the government's NHS reforms.
Mr Lansley had called for nurses to show "clinical leadership" in his speech and described them as the "heart and backbone of the NHS".
That did not stop contributions from the floor making clear nurses' hostility to the Health and Social Care Act, which is now being transferred to concerns about the impact of their "facade" on overburdened community care services.
"If any of you have a view that staffing levels are literally not safe for patients, I think part of your professional responsibility is to say that," Mr Lansley said in response to one critical question.
That met with a vocal response from the audience. RCN's chief executive and general secretary Peter Carter said: "I hope you are hearing my colleagues out there are really concerned that people are listening and then taking action about what they are hearing."
Mr Lansley prompted a second bout of heckling when he claimed that the Health and Social Care Act did not represent the privatisation of the NHS.
"Let's not have an argument about it now," he pleaded with the audience as they made their feelings on the matter clear at volume.
A survey of members published as the college met for its annual congress found just six per cent felt they always had time to meet the needs of their patients.
Nearly 60% said they were spending less time with their patients than they were a year ago, leading the RCN's bosses to claim that the shift from acute hospitals to community care is not working.
Dr Carter warned that nurses were struggling to keep patients out of hospital - and struggling to discharge them with support when they leave.
"This is a revolving door for patients, but it also represents a false economy at a time when there is no money to spare," he said.
"We want care to be delivered closer to home, and we want community nurses to be empowered to keep their patients out of hospital, but at the moment this shift in the way care is delivered is simply a facade, with the community struggling to cope with the workload it has now, let alone the one it faces in the future."
According to the RCN more than 61,000 NHS posts are at risk of being cut. The move to community care is being used as a cover for cutting hospital jobs which are not being replaced elsewhere, it claims.
Yesterday its president Andrea Spyropoulos said nurses were working in a "climate of fear" over their jobs, pay and pensions.
"I say to you – have no fear, have the courage to take ownership of nursing, demand the resources to deliver for patients," she told nurses.
"We will stand together for the good of our patients and our profession."