All NHS services will be ranked in a new league table system, with hospital managers fired if they don't improve the quality of patient care and financial management. Wes Streeting, the UK's new health secretary, told a conference of NHS providers yesterday the reforms will mean "no more rewards for failure". NHS trusts that sit higher in the (publicly available) league table will get a longer leash from Whitehall and freedom to use budget surpluses for infrastructure investment. Streeting's promise is that the reforms will help cut a 7.6 million-long waiting list and keep the NHS living "within its means". The reforms have been welcomed by NHS England's chief executive, Amanda Pritchard. But trust leaders have criticised the principle of league tables as a way of improving performance. Alan Milburn, newly appointed to a top job in the Department for Health, launched a "star rating" scheme for hospitals in 2002 under Blair. They were scrapped in 2005.