OPPOSITION attacks on the Government over allegedly "fiddled" hospital star ratings have switched from former Health Secretary Alan Milburn to Prime Minister Tony Blair.

The Tories went on the offensive last week when a leaked memo revealed that Mr Milburn intervened last year after his local hospital trust seemed likely to lose one of its three stars.

A day later, the trust - which includes Darlington Memorial Hospital and Bishop Auckland General Hospital - regained its third star.

Mr Milburn has described suggestions that he fiddled the rating as "complete tosh".

But now the Conservatives have seized on the fact that Mr Milburn's e-mail to NHS officials about the then South Durham trust was copied to Simon Stevens, Mr Blair's health policy advisor in Downing Street.

While Downing Street insists that the e-mail was not acted upon, the admission that Number 10 was notified has galvanised the Tories into action.

Party chairman Dr Liam Fox, formerly the Tories' health spokesman, said the "direct involvement" of the office of the Prime Minister threatened to undermine "the very integrity of the process of Government".

Dr Fox has written to Sir Andrew Turnbull, secretary to Mr Blair's cabinet, pointing out that the situation was causing "enormous concern".

Dr Fox said the whole affair had revealed the "direct political involvement of ministers in order to manipulate the NHS for their direct political needs".

Mr Milburn, MP for Darlington, has pointed out that the South Durham trust was just one of four trusts mentioned in the e-mail and two of them were not upgraded.

He said there was "a world of difference between asking a question and giving an instruction".

In this year's star ratings, the trust, which is now known as the County Durham and Darlington Hospitals NHS Trust and includes the University Hospital of North Durham, went down to two stars.