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
Arts and Entertainment
The Doctor and Clara have their first real heart to heart since he regenerated in 'Deep Breath'
TV
Life and Style
Apple showed no sign of losing its talent for product launches with the new, slightly larger iPhone 6 making headlines
techSecurity breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Arts and Entertainment
Jamie Oliver
filmTV chef Jamie Oliver turned down role in The Hobbit
News
The official police photograph of Dustin Diamond taken after he was arrested in Wisconsin
peopleDownfall of the TV star charged with bar stabbing
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
tvReview: Top Gear team flee Patagonia as Christmas special reaches its climax in the style of Butch and Sundance
News
people
Sport
Ashley Barnes of Burnley scores their second goal
footballMan City vs Burnley match report
Arts and Entertainment
Peter Mayhew as Chewbacca alongside Harrison Ford's Han Solo in 'Star Wars'
film
News
i100
Arts and Entertainment
Man of action: Christian Bale stars in Exodus: Gods and Kings
film
Arts and Entertainment
Tracy Emin's 1998 piece 'My Bed' on display at Christie's
artOne expert claims she did not
News
Ernesto Che Guevara and Fidel Castro, right, met at Havana Golf Club in 1962 to mock the game
newsFidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
News
Hackers revealed Oscar-winning actress Lawrence was paid less than her male co-stars in American Hustle
people
Arts and Entertainment
Clueless? Locked-door mysteries are the ultimate manifestation of the cerebral detective story
booksAs a new collection of the genre’s best is published, its editor explains the rules of engagement
Sport
Robin van Persie is blocked by Hugo Lloris
footballTottenham vs Manchester United match report
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: Business Manager

£32000 - £40000 per annum: Recruitment Genius: A Business Manager is required ...

Recruitment Genius: Operations Manager

£45000 - £55000 per annum: Recruitment Genius: This is an exciting opportunity...

Recruitment Genius: Panel & Cabinet Wireman

£20000 per annum: Recruitment Genius: Panel Wireman required for small electro...

Recruitment Genius: Electronics Test Engineer

£25000 - £27000 per annum: Recruitment Genius: An SME based in East Cheshire, ...

Day In a Page

A timely reminder of the bloody anniversary we all forgot

A timely reminder of the bloody anniversary we all forgot

Who remembers that this week we enter the 150th anniversary year of the end of the American Civil War, asks Robert Fisk
Homeless Veterans appeal: Former soldiers pay their respects to a friend who also served

Homeless Veterans appeal

Former soldiers pay their respects to a friend who also served
Downfall of Dustin 'Screech' Diamond, the 'Saved By The Bell' star charged with bar stabbing

Scarred by the bell

The downfall of the TV star charged with bar stabbing
Why 2014 was a year of technological let-downs

Why 2014 was a year of technological let-downs

Security breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Cuba's golf revolution: But will the revolutionary nation take 'bourgeois' game to its heart?

Will revolutionary Cuba take 'bourgeois' golf to its heart?

Fidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
The Locked Room Mysteries: As a new collection of the genre’s best is published, its editor Otto Penzler explains the rules of engagement

The Locked Room Mysteries

As a new collection of the genre’s best is published, its editor explains the rules of engagement
Amy Adams on playing painter Margaret Keane in Tim Burton's Big Eyes

How I made myself Keane

Amy Adams hadn’t wanted to take the role of artist Margaret Keane, because she’d had enough of playing victims. But then she had a daughter, and saw the painter in a new light
Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

Parting view of Ofcom chief... we hate jokes on the disabled

Bad language once got TV viewers irate, inciting calls to broadcasting switchboards. But now there is a worse offender, says retiring head of the media watchdog, Ed Richards
A look back at fashion in 2014: Wear in review

Wear in review

A look back at fashion in 2014
Ian Herbert: My 10 hopes for sport in 2015. Might just one of them happen?

Ian Herbert: My 10 hopes for sport in 2015

Might just one of them happen?
War with Isis: The West needs more than a White Knight

The West needs more than a White Knight

Despite billions spent on weapons, the US has not been able to counter Isis's gruesome tactics, says Patrick Cockburn
Return to Helmand: Private Davey Graham recalls the day he was shot by the Taliban

'The day I was shot by the Taliban'

Private Davey Graham was shot five times during an ambush in 2007 - it was the first, controversial photograph to show the dangers our soldiers faced in Helmand province
Revealed: the best and worst airlines for delays

Revealed: the best and worst airlines for delays

Many flyers are failing to claim compensation to which they are entitled, a new survey has found
The stories that defined 2014: From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions

The stories that defined 2014

From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions
Stoke-on-Trent becomes first British city to be classified as 'disaster resilient' by the United Nations

Disaster looming? Now you know where to head...

Which British city has become the first to be awarded special 'resilience' status by the UN?