We cannot afford not to reform NHS, says David Cameron

The Government cannot afford to delay essential reform of Britain's public services, David Cameron warned today.

As ministers prepared to publish legislation to radically overhaul the NHS, the Prime Minister said that failure to modernise was draining resources away from the public sector.



In a keynote speech at the Royal Society of Arts in London, he dismissed suggestions that services could carry on as they were as "a complete fiction".



The Government's plans for the NHS were denounced today by six health service unions - including the British Medical Association and the Royal College of Nursing - as "potentially disastrous".



But Mr Cameron insisted that change was essential.



"Every year without modernisation the costs of our public services escalate. Demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.



"Pretending that there is some 'easy option' of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.



"We need modernisation, on both sides of the equation. Modernisation to do something about the demand for healthcare, which is about public health. And modernisation to make the supply of healthcare more efficient, which is about opening up the system, being competitive and cutting out waste and bureaucracy.



"Put another way: it's not that we can't afford to modernise; it's that we can't afford not to modernise."









With the Government also set to publish details of its school reforms next week, Mr Cameron cited the experience of Tony Blair, who found that delaying public service reform simply resulted in "institutional inertia" against change.



He acknowledged that in the past the Conservatives had not always shown sufficient respect for those who worked in public services, but insisted he would "revere, cherish and reward" an ethos of public service.



"I believe previous Conservative governments had some really good ideas about introducing choice and competition to health and education - so people were in the driving seat. But there was insufficient respect for the ethos of public services - and public service," he said.



"The impression was given that there was a clear dividing line running through our economy, with the wealth creators of the private sector on one side paying for the wealth consumers of the public sector on the other.



"This analysis was - and still is - much too simplistic. Public sector employees don't just provide a great public service - they contribute directly to wealth creation."



He denied he was planning "a kind of public service version of a laissez-faire economic policy" with the Government's reforms for schools and hospitals, "where winners are created at the expense of those who get left behind".



"The state has a hugely important responsibility to ensure clear, basic standards are met, the rights of users are maintained and independent inspection is carried out in our public services and we are in no way abrogating that," he said.



The Prime Minister also rejected suggestions that the Government was trying to do "too much at once" in pushing through change.



"Every year we delay, every year without improving our schools is another year of children let down, another year our health outcomes lag behind the rest of Europe, another year that trust and confidence in law and order erodes," he said.



"These reforms aren't about theory or ideology - they are about people's lives. Your lives, the lives of the people you and I care most about - our children, our families and our friends.



"So I have to say to people: if not now, then when? We should not put this off any longer."







Mr Cameron also explained comments in which he appeared to describe the NHS as a second-rate National Health Service as a slip of the tongue.



His slip-up came during a radio interview this morning on BBC Radio 4's Today programme.



Asked if he would apologise for using the term, Mr Cameron said: "I think if you listen to the interview, I immediately said we shouldn't settle for second best and that is exactly what I meant to say.



"I speak often quickly, I don't just have a pre-arranged order of saying things and sometimes you can get a little word out of place and I immediately said, if you listen to the clip, we shouldn't settle for second best, that was the point I was making."



To widespread guffaws from the assembled media, he added: "We shouldn't settle for second best is what I meant, it's largely what I said, if you skip over a quick word in the middle."







In a letter to The Times today ahead of Wednesday's publication of the Health and Social Care Bill, the heads of six health unions expressed their "extreme concerns" about plans to create greater commercial competition between the NHS and private companies within the health service.



The signatories, including BMA chairman Hamish Meldrum, RCN chief executive Peter Carter and the heads of health for the Unison and Unite unions, said: "There is clear evidence that price competition in healthcare is damaging."



It follows a report by the NHS Confederation which acknowledged the potential benefits of the changes, which will give GPs power over commissioning treatment, but warned they were "extraordinarily risky" at a time when the NHS is facing its toughest financial constraints for a decade.



TUC general secretary Brendan Barber said the Government's plans would lead to the "destruction" of quality services across the public sector.



"Ministers are using the challenge of the deficit to cover a fundamental transformation of public services, which voters would have rejected if it had been put forward at the General Election," he said.



"We are not talking about a few years of economy as the deficit reduces, but a systematic and permanent reduction in services.



"The Government's clear aim is a permanently smaller state, markets taking over from public accountability and privatisation's profit motive replacing public service - deficit reduction is just the cover story."

Start your day with The Independent, sign up for daily news emails
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
News
Nick Clegg on the campaign trail in Glasgow on Wednesday; he says education is his top priority
peopleNick Clegg remains optimistic despite dismal Lib Dem poll ratings
Arts and Entertainment
Déjà vu: David Tennant returns to familiar territory with Anna Gunn (‘Breaking Bad’)
tvReview: Something is missing in Gracepoint, and it's not just the familiar names
Arts and Entertainment
Buttoned up: Ryan Reynolds with Helen Mirren in ‘Woman in Gold’
filmFor every box-office smash in his Hollywood career, there's always been a misconceived let-down. Now he says it's time for a reboot
News
people
News
Actress Julianne Moore wins the Best Actress in a Leading Role Award for 'Still Alice' during the 87th Annual Academy Awards in Hollywood, California
people
Sport
Ross Barkley
footballPaul Scholes says it's time for the Everton playmaker to step up and seize the England No 10 shirt
News
'We will fix it': mice in the 1970s children’s programme Bagpuss
science
Life and Style
2 Karl Lagerfeld and Choupette
fashion
  • Get to the point
2015 General Election
May2015

Poll of Polls

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Bookkeeper

£23000 - £28000 per annum: Recruitment Genius: This fast growing boutique prac...

Recruitment Genius: Customer Service Executive

£18000 - £22000 per annum: Recruitment Genius: This is an exciting opportunity...

Recruitment Genius: Retail Buyer / Ecommerce Buyer

£30000 - £35000 per annum: Recruitment Genius: Working closely with the market...

Recruitment Genius: Sales Executive - CAD Software Solutions Sales

£20000 - £50000 per annum: Recruitment Genius: A reputable company, famed for ...

Day In a Page

War with Isis: Iraq declares victory in the battle for Tikrit - but militants make make ominous advances in neighbouring Syria's capital

War with Isis

Iraq declares victory in the battle for Tikrit - but militants make make ominous advances in neighbouring Syria
Scientists develop mechanical spring-loaded leg brace to improve walking

A spring in your step?

Scientists develop mechanical leg brace to help take a load off
Peter Ackroyd on Alfred Hitchcock: How London shaped the director's art and obsessions

Peter Ackroyd on Alfred Hitchcock

Ackroyd has devoted his literary career to chronicling the capital and its characters. He tells John Walsh why he chose the master of suspense as his latest subject
Ryan Reynolds interview: The actor is branching out with Nazi art-theft drama Woman in Gold

Ryan Reynolds branches out in Woman in Gold

For every box-office smash in Ryan Reynolds' Hollywood career, there's always been a misconceived let-down. It's time for a rethink and a reboot, the actor tells James Mottram
Why Robin Williams safeguarded himself against a morbid trend in advertising

Stars safeguard against morbid advertising

As film-makers and advertisers make increasing posthumous use of celebrities' images, some stars are finding new ways of ensuring that they rest in peace
The UK horticulture industry is facing a skills crisis - but Great Dixter aims to change all that

UK horticulture industry facing skills crisis

Great Dixter manor house in East Sussex is encouraging people to work in the industry by offering three scholarships a year to students, as well as generous placements
Hack Circus aims to turn the rule-abiding approach of TED talks on its head

Hack Circus: Technology, art and learning

Hack Circus aims to turn the rule-abiding approach of TED talks on its head. Rhodri Marsden meets mistress of ceremonies Leila Johnston
Sevenoaks is split over much-delayed decision on controversial grammar school annexe

Sevenoaks split over grammar school annexe

If Weald of Kent Grammar School is given the go-ahead for an annexe in leafy Sevenoaks, it will be the first selective state school to open in 50 years
10 best compact cameras

A look through the lens: 10 best compact cameras

If your smartphone won’t quite cut it, it’s time to invest in a new portable gadget
Paul Scholes column: Ross Barkley played well against Italy but he must build on that. His time to step up and seize that England No 10 shirt is now

Paul Scholes column

Ross Barkley played well against Italy but he must build on that. His time to step up and seize that England No 10 shirt is now
Why Michael Carrick is still proving an enigma for England

Why Carrick is still proving an enigma for England

Manchester United's talented midfielder has played international football for almost 14 years yet, frustratingly, has won only 32 caps, says Sam Wallace
Tracey Neville: The netball coach who is just as busy as her brothers, Gary and Phil

Tracey Neville is just as busy as her brothers, Gary and Phil

The former player on how she is finding time to coach both Manchester Thunder in the Superleague and England in this year's World Cup
General Election 2015: The masterminds behind the scenes

The masterminds behind the election

How do you get your party leader to embrace a message and then stick to it? By employing these people
Machine Gun America: The amusement park where teenagers go to shoot a huge range of automatic weapons

Machine Gun America

The amusement park where teenagers go to shoot a huge range of automatic weapons
The ethics of pet food: Why are we are so selective in how we show animals our love?

The ethics of pet food

Why are we are so selective in how we show animals our love?