A sweating Tony Blair yesterday insisted the NHS was not in crisis as he attempted to head off a potential voter backlash resulting from hospital cuts across the country.

The Prime Minister said budget deficits were a result of "re-engineering" which would change the NHS for the better.

Less than 24 hours after the head of Birmingham Children's Hospital warned the new NHS payments system was placing vital services under an untolerable strain, Mr Blair said it was "the moment to hold our nerve". However, the glowing PM seemed to have trouble keep-ing his customary cool as sweat poured off his forehead under the hot lights.

Mr Blair and Health Secretary Patricia Hewitt have drawn up plans to cope with the political fallout from hospital job cuts across the country, it was revealed yesterday.

Ministers reportedly fear a repeat of the wave of public anger that followed major cuts at Kidderminster Hospital in 2001 and led to the election of independent MP Richard Taylor in Wyre Forest, Worcestershire - the so-called "Kidderminster effect".

The retired consultant retained the seat in last year's poll.

The West Midlands, which contains a number of key marginal seats, has suffered the most dramatic job cuts.

University Hospital Staffordshire is losing 1,000 posts and last week Sandwell and West Birmingham Hospitals NHS Trust announced it was to lose 800 positions.

Hundreds more jobs are being lost at New Cross Hospital in Wolverhampton, Walsgrave Hospital in Coventry, Royal Shrewsbury and Telford NHS Trust in Shropshire, and Worcestershire Royal Hospital in Worcester.

Speaking to consultants and health managers in London, Mr Blair admitted that the scale of the challenge to deliver a new NHS was "very, very tough".

Patients were being given a choice over where they were treated and the way hospitals received funding had changed, he said.

"Obviously it is a huge process of re-engineering. It is not in the least surprising that it is causing difficulty and turbulence."

But the reforms had simply exposed poor financial management and had not actually created the deficits, he said.

"This is not the moment to back away or dilute these changes, but rather the moment to hold our nerve, back the change-makers in the NHS who are making it happen, and see the process of change through."

The Prime Minister came under fire from Unison, which represents many NHS workers.

Spokeswoman Karen Jennings said: "Blair may say we need to hold our nerve over NHS reforms - I say that he has a nerve to sit back and oversee hospitals closing, swingeing job cuts and privatisation.

"These 'difficult transitions' equate to more than 10,000 job cuts so far, and more on the way."

The Royal College of Nursing has launched a petition against the job losses.

It emerged yesterday some GPs are now earning as much as £250,000 a year because of the NHS reforms.