Speaking at the RCN Congress on Tuesday, Andrew Lansley said there were an ‘awful lot of people out there' who don't understand the need for the reforms, or why community services are being moved out of the control of primary care and into the hands of other organisations'.

‘There seems to be far too little consultation with the staff who are affected, and far too few options,' he said.

A Tory government would create opportunities for community foundation trusts (CFTs), so nurses can reap ‘all the benefits of employee ownership'.

‘I think there is a real opportunity for staff in community services right across the country to become part of CFTs, to be your own bosses, take control, and  join us in delivering the public services you want, free from the top-down system of control and bureaucracy that gets in the way of delivering the best possible care,' Mr Lansley told the conference.

• Transforming Community Services reforms guidance

The Tory shadow health secretary received his first applause ten minutes into his speech when he said he would ‘disempower the hierarchy in the NHS'.

He said: ‘We have a million health professionals in this service who know what they should be doing, and need to be given the power to do it.

‘We are going to give the NHS day-to-day autonomy so we don't have constant political interference, and make a department of public health that is focussed on delivering the public health objectives that really matter.'

RCN head of policy Howard Catton said Mr Lansley's speech included some ‘very strong messages for nurses'.

Dr Peter Carter, RCN chief executive and general secretary, said Liberal Democrat leader Nick Clegg and prime minister Gordon Brown 'said a lot of things our members want to hear' in their speeches to the congress. 'And we liked a lot of what they were saying. Andrew Lansley by contrast came at it from a totally different perspective. What he demonstrated is that he really understands the detail.'

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