GPs are coming under pressure to extend surgery hours

Gordon Brown was speaking at a meeting of 1,000 people to discuss the future of the NHS in Birmingham.

The "citizens' jury" was one of nine held around England on Tuesday, each designed to canvas public opinion about health service reform.

Mr Brown said GPs should be more accessible at weekends and in the evenings.

He also highlighted hospital cleanliness as another priority, and said the government would consider increasing the number of matrons working in the NHS.

The changes in the health service that the public are telling us are needed are the changes we are going to bring about Gordon Brown CBI demands GP 'overhaul'

Mr Brown said: "What I am hearing, and what I am going to act upon is that people want more access to the GP out-of-hours, and at weekends.

"They want higher quality of service and personal care when they go to the hospital.

"They want the hospital to be clean, and they want it to be safe.

"The changes in the health service that the public are telling us are needed are the changes we are going to bring about."

The Confederation of British Industry is also calling for greater access to GPs, arguing that businesses lose 38m working hours and £1bn a year because employees have to visit their GP during working hours.

But the British Medical Association has warned that GPs are already hard-pressed, and that an extension in access to services must be coupled with an expansion in doctor numbers.

Major consultation

The "citizens' juries" initiative is part of the review of the NHS in England led by Lord Darzi, a minister and surgeon.

Ministers say it will set priorities for the next 60 years with key themes being access, quality and safety.

No-one really has any confidence in consultations nowadays because so often they amount to nothing more than a sham Norman Lamb, of the Lib Dems

But opponents say the consultation is a "sham" which ministers will ignore.

Lord Darzi is said to favour giving patients more choice of primary care services.

It is reported that he has called a meeting of potential providers, including private operators such as Bupa.

He is also set to meet retailers such as Boots, Lloyds Pharmacy and Sir Richard Branson's Virgin Group to discuss the establishment of primary care facilities on the high street.

The juries will meet again later in the year before feeding into the review's final report, which is due next summer. An interim report will also be published in October.

The juries are asked a series of questions. These include:

• What are your main concerns for health care in the future?
• What are the most important factors in delivering a high quality service?
• What would help demonstrate that the service is safe, effective and high quality?
• What actions would you like to see to tackle the spread of infections in hospitals?
• What are the current barriers to accessing health services?

'Top down'

Alan Johnson, the Health Secretary, said the focus was on identifying key priorities for each region as the government was not seeking a "top down" solution.

"We want to empower people and give them a say on their NHS.

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"This is a look towards the next 10 years and actually delivering a health care system that is focused completely on patient care that moves away from the structural reorganisations that we have had in the past."

Mr Johnson was also forced to defend the review which comes just two years after previous health secretary Patricia Hewitt carried out a nationwide public consultation involving patient summits.

"This is not just a listen and learn event. It's more engage and involve."

But Lib Dem health spokesman Norman Lamb said: "No-one really has any confidence in consultations nowadays because so often they amount to nothing more than a sham."

And the Conservatives say on past form, ministers do not listen but press on with their own agenda.

Andrew Lansley, the Shadow Health Secretary, said: "After ten years, Labour still don't know what kind of service people want from the NHS. That's because they aren't listening.

"Past listening exercises show that they simply don't take the public's opinion on board.