Breaking with a decade-old tradition, Mr Milburn became the first secretary of state to use the "R" word, carefully avoided by his predecessors, but insisted every healthcare system had to make hard choices.
He promised to end the "lottery of care" generated by the pick-and-mix system of postcode prescribing and replace it with a fairer system based on a scientific assessment.
Speaking to the first conference of the National Institute of Clinical Excellence (Nice) in Harrogate, Mr Milburn sought to put clear water between Labour and Tory policies on the NHS by insisting its needs could be met from taxation.
His remarks came as doctors' leaders meeting at the British Medical Association yesterday called for a no-holds- barred review of funding for the NHS. They joined a growing cacophony of voices insisting that demands on the NHS are increasingly outstripping the Treasury's capacity to fund it.
Mr Milburn rejected the claim that charges would fall on the elderly and the young, who had most need of the NHS but who could least afford to pay, while private insurance would be affordable only to those least likely to claim on it.
"The NHS is both fairer and more efficient than the privatised alternative. We reject the private option as intrinsically flawed," he said.Reuse content