Cameron warns Tories to swallow painful medicine to regain power

David Cameron presented himself as Tony Blair's natural heir as he warned the Conservative Party it would have to swallow some painful medicine in order to regain power.

The Tory leader closed his party's Bournemouth conference with an uncompromising message that it must be prepared to adopt unpopular policies to combat climate change, should accept housebuilding in the green belt, and value a gay marriage as much as one between a man and woman.

His audience applauded warmly despite being repeatedly warned that the Tories would face some "painful" decisions on policy. "We must show we understand the price of progress, and tell people what it is," he said. "Making out that everything is possible, everything is easy, it's all painless - that is spin. That is what we have had these past nine years. We must be different."

Without mentioning Gordon Brown, his most likely opponent at the next general election, Mr Cameron argued that a Tory government led by him would preserve the best aspects of the Blair era while changing the worst. Mr Brown is likely to adopt a similar approach if he succeeds Mr Blair but the Tories will try to associate him with the "old regime".

"Not everything that Labour has done since 1997 is bad," said Mr Cameron. "People don't want us to turn the clock back. They want us to improve the bad things, yes. But they also want us to keep the good things."

He promised to end Mr Blair's informal "sofa government" and restore power to the full Cabinet. "I want to be Prime Minister of Britain. I don't want to be a president," he said.

A "steadfast, not slavish" approach to relations with Washington would mean he was "a British Prime Minister who pursues a British foreign policy," he said.

After Labour suggestions that he was soft on crime, he claimed that the Tories were now the only party to support Mr Blair's mantra of being "tough on crime and tough on the causes of crime."

Mr Cameron showed his determination to occupy Labour's traditional ground by making the National Health Service his top priority. He reminded the public that his family relied on it because he has a disabled four-year-old son. "The NHS is an expression of our values as a nation. It is a symbol of collective will, of social solidarity," he said.

Spelling out what he called "uncomfortable truths", he said that low-energy light bulbs, hybrid cars and windmills on roofs would not be enough to tackle the threat from climate change. The Government had to show leadership by setting the right framework and ensuring that things producing more carbon were more expensive.

"Going green is not some fashionable, pain-free alternative. It will place a responsibility on business. It will place a responsibility on all of us," he said.

Tackling another Tory taboo - building in the countryside - he said that to be the "party of aspiration" it would have to support the provision of more houses and flats so that young people in particular could enjoy home ownership. "If we want new homes, they have to be built somewhere," he said, adding there was "no pain-free solution" to satisfy every vested interest.

He extolled the importance of the family and said marriage was "a vital institution" that should be rewarded through the tax system. The commitment involved in marriage "means something whether you're a man and a woman, a woman and a woman or a man and another man." He said that he was "proud" that the Conservatives supported civil partnerships.

Mr Cameron backed faith schools but risked controversy by saying that Muslim schools should admit a quarter of pupils from other religions as an example of "social responsibility".

He said: "If these schools are to be British state schools, they must be part of our society, not separate from it," he said. However, a Conservative government would not enforce a quota by legislation.

He warned Tory right-wingers to drop their demand for him to "flash up some pie-in-the-sky tax cuts just to show what we stand for." He told his internal critics bluntly: "When some people talk about substance, what they mean is they want the old policies back. Well, they're not coming back, and we're not going back."

Urging his party to be "optimistic" about a Britain whose "best is yet to come", the Tory leader said: "We must not be the party that says the world and our country is going to the dogs. We must be the party that lifts people's sights and raises their hopes.

"For years, we Tories have talked about rolling back the state. But that is not an end in itself. Our fundamental aim is to roll forward the frontiers of society," he said.

Mr Cameron drew criticism from the pressure group Liberty after promising to replace the Human Rights Act with a British bill of rights. Shami Chakrabarti, its director, who appeared on the conference platform this week, described the move as "disappointing and dangerous nonsense" which would undermine Mr Cameron's efforts to rebrand his party.

What does the NHS need?

Niall Dickson King's Fund chief executive

"First, the service must be restored to financial balance. Second, we need big changes in the way care is delivered. Third we must put in place the skills, incentives and data to commission and monitor local services that offer choice to patients. Integral to all this will be involving clinical staff in making the system work better. One last plea - no more reorganisations."

Joanna Chikwe Heart surgeon

"If he can stop the flow of NHS billions into the profit margins of consultants and lawyers, and repair the damage done by dumbing down doctors' training, he's got my vote."

Pat Morris NHS campaigner

"The NHS is not a policies football. Agreement should be reached by all parties to put the patients first and not their political agendas."

James Johnson BMA Chairman

"Clinicians must have a say in how the NHS is run. Doctors want to see policies that allow patients to be placed at the centre of health care."

Buzzwords

* Responsibility 22

* Substance 12

* Family 11

* Policy 9

* Tax 9

* Tony Blair 7

* Prime Minister 7

* Environment 7

* Economy 7

* Security 6

* Progress 5

* Threat 5

* Terrorism 4

* Green 3

* Centre ground 1

* Ideas 1

* Gordon Brown 0

* Sunshine 0