Private providers of National Health Service care on Tuesday accused Andy Burnham, the health secretary, of being “completely irresponsible” in rolling back competition by making NHS organisations the “preferred provider” of care.

The health department is due to issue guidance advising that NHS organisations must be given “at least two formal chances” to improve where they are under-performing. Even then, other potential providers should be considered only where the under-performance is “significant”, according to draft guidance agreed with the health service unions.