David Cameron stepped up his bid to make the Tories the party of the NHS today by promising reforms to cut costs and extend "patient power".
The Conservative leader repeated his pledge to ring-fence the health budget, but insisted that money would be better spent.
The £4.5bn annual bill for administering the NHS is "astonishing", and must be slashed by a third over the next four years, he said.
In a speech in London setting out Tory priorities for the NHS, Mr Cameron insisted: "Spending on the NHS cannot stand still.
"But that does not mean we are simply going to pour money in as Labour have done.
"If we change nothing, and if productivity keeps falling at the rate it is today, then even with real-terms increases in spending we couldn't hope to cope with the pressures on the NHS.
"That's why, as well as those increases, we urgently need reform to make our whole health service more efficient.
"We are determined that a Conservative pound will go much further than a Labour pound."
Mr Cameron said closures of A&E and maternity units as part of reorganisations would be halted.
Top-down targets had "drained morale to an all-time low and wasted time and money" and would be scrapped, giving doctors and nurses freedom to take decisions based on "clinical imperatives", according to the Tory leader.
That would not mean that health professionals were "privileged over the patient", because individuals would have greater control over where to get treatment.
"Instead of answering to the bureaucrats and the politicians, they will be answering to you, the patient," Mr Cameron said.
"The boss won't be some pen-pusher at a distant PCT (primary care trust) but the woman who needs a cataract operation, the parent of the child in A&E, the man given physiotherapy as an outpatient after a stroke.
"That's because all the information on hospitals' performance will be published online, in detail, from the success they've had with heart transplants, to cancer survival rates, to how patients rate their quality of care."