Gordon Brown has signalled a major expansion of private sector involvement in health provision today as he fights to revive his political fortunes.

The Prime Minister unveilled a series of policy shifts designed to give people more power over public services.

Among the most radical moves will be giving patients cash to go private if NHS Trusts cannot meet the 18-week target between GP referral and treatment.

Cancer sufferers would be able to take their funding elsewhere if they are not given a specialist appointment within two weeks. Similar "entitlements" are being considered for accessing an NHS dentist, late opening hours for GPs at weekends, and getting palliative care at home.

The amount of money would be equivalent to the cost of the treatment on the NHS, and Trusts that fail to meet their obligations could also face other financial penalties.

The changes are likely to be portrayed as a climbdown by Mr Brown, who battled against less drastic Blairite efforts to involve the private sector in public services. There are similarities to the "Patient's Passport" policy dropped by the Tories after the last general election. Currently only elective surgery such as hip replacements and cataract surgery is provided through private treatment.

However, after a series of dire poll results and leadership speculation, aides hope that a new policy platform can counter criticism that the Government is "drifting" and get Mr Brown back on track.

The premier will attend a series of events today to launch the "Building Britain's Future" document.

Other pledges are expected to include freeing up local authorities on housing allocation so priority can be given to people with ties to the community. The BNP exploited anger over the perception that immigrants are pushed to the top of housing lists during recent local and euro elections.

There will also be a "significant" expansion of funding for social housing, and the scrapping of "top-down" targets across services, according to Government sources.

Meanwhile, the row between the main parties over public spending cuts raged on.

Schools Secretary Ed Balls yesterday admitted the Government faced "tough choices" in order to balance its books, but insisted that investment in "front line" services could be maintained if the economy recovered.

However, shadow Treasury chief secretary Philip Hammond accused ministers of having "something to hide", amid reports that the Comprehensive Spending Review has been put off. The delay could mean voters will not have full details of Government plans at the general election.

Another crucial challenge for Mr Brown moved a step closer when Labour selected its candidate for the Norwich North by-election.

Chris Ostrowski will bid to replace Ian Gibson, who opted to quit immediately this month after Labour's "Star Chamber" panel barred him from standing for re-election.

He had been accused of abusing Commons expenses by selling a taxpayer-funded property to his daughter at a knock-down price. A date has yet to be set for the poll.

By coincidence, Mr Ostrowski currently works for the retailer that came to symbolise the Westminster allowances culture, John Lewis.