The prime minister, Tony Blair, suffered his second verbal attack at a hospital in five weeks today - as he pledged to curb abuse against NHS staff.

A waiting patient at the Royal London Hospital confronted Mr Blair with the words: "Oi! Blair you tosser! Like to see you waiting here for six hours."

Patient Martin Wright tackled him in the east London hospital's accident and emergency ward, shouting at him across the crowded waiting area, just weeks after his haranguing from angry patient's partner Sharron Storer made pre-election headlines.

Mr Blair was at the hospital to deliver a pledge to the government to do all it could to "turn back the tide" of violence against NHS staff.

Self-styled anarchist Mr Wright said he had arrived at the hospital to be seen for an intestinal problem at 11am and did not expect to be seen until 4pm. The 48-year-old from east London brandished a copy of the pro-violence anarchist newsletter Class War as he confronted Mr Blair, but the prime minister passed him without comment.

Mr Wright said: "He has just got himself a £40,000 pay rise and yet how much did the ancillary staff and the nurses get? How much are they going to be getting - very little I would imagine."

He said nurses and hospital staff worked in difficult conditions and struggled to find affordable accommodation.

Mr Blair first came under attack last month during the general election campaign, on a visit to the Queen Elizabeth Hospital in Birmingham. He was ambushed by Ms Storer who was angry at the treatment her partner, critically ill cancer patient Keith Sedgwick, was receiving.

Earlier today Mr Blair said he had been "shocked" by the level of violence and abuse suffered by frontline NHS staff - a total of 65,000 incidents were reported last year alone.

Mr Blair was visiting a "red card" scheme aimed at deterring violence against staff working at the Bart's and the London NHS trust, which covers Bart's, the Royal London and the London chest hospital. Under the scheme, persistent offenders can face a year-long ban from the trust.

They are warned verbally that if they persist they are given a written warning known as a yellow card. If the abuse persists, a senior manager or member of clinical care can issue a "red card" and exclude the patient from the hospital.

Emergency treatment is given to patients who have been excluded, but staff will seek to transfer the patient as soon as possible.