Rishi Sunak was confronted by a 77-year-old NHS patient on nurses’ pay during a visit to a hospital in south London.
Catherine Poole, who is recovering from surgery at Croydon University Hospital, said “it’s a pity you don’t pay them more” when asked how the nurses were treating her.
The prime minister insisted “we are trying”, but was given a short lecture from the pensioner.
“No, you are not trying, you need to try harder,” she told him.
Mr Sunak went on to say that the NHS was important. “Yes, and look after it,” Ms Poole replied.
Thousands of nurses across the country are voting on strike action, as healthcare workers call for a pay rise amid soaring inflation.
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Research commissioned by the Royal College of Nursing suggested that they are working an extra day a week for no more pay.
The data also suggests their wages have fallen 20% in real terms, based on a five-day week.
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The NHS could also be in line for a further tightening of budgets, as Chancellor Jeremy Hunt eyes ways to fill a multi-billion pound fiscal black hole.
Mr Sunak dodged a question about nurses’ pay, when pushed by broadcasters following the exchange.
Asked if he was happy that nurses are not getting a real-terms increase in pay, he said: “It is brilliant to be here at Croydon Hospital, to see the great work of the doctors and nurses here.
“One of the priorities for my government is going to be tackling the COVID backlogs and supporting the NHS.
“We face lots of challenges as a country, but I am confident that we can fix the economy and deliver on the promise of the 2019 manifesto, including having a stronger NHS.”
Mr Sunak received a more positive reaction from other patients.
At one bed, 46-year-old Sreeja Gopalan told him: “I am waiting to see you.”
“I am proud of you,” she said, as she took a selfie with the prime minister.
During the summer Conservative leadership contest, Mr Sunak pledged to introduce a £10 fine.
Among the critics, the British Medical Association (BMA) said the plans would “make matters worse” and threaten the principle of free NHS care at the point of need.
The prime minister wants to deliver a stronger NHS and the “sentiment remains people should not be missing appointments”, according to his spokesperson.