I will go where Blair feared to tread, says PM

David Cameron pledged to succeed where Tony Blair failed yesterday as he launched a new phase of the Coalition Government's sweeping plans to reform public services.

Mr Cameron argued the former prime minister delayed big changes to health and education after winning power in 1997 and was then thwarted by "vested interests" such as the trades unions.

In a speech to the RSA think-tank, Mr Cameron said: "Tony Blair introduced academies and increased independent provision in the NHS. But he did so while maintaining a whole architecture of bureaucracy and targets and significantly understating the valuable role of charities and the voluntary sector. What's more, when he did try to be bolder he got blocked by – and too often surrendered to – vested interests. Foundation hospitals could only go ahead with endless restrictions on what they could do. School reform could only go at a pace that the trade unions – and Gordon Brown – could tolerate."

Answering questions after his speech, the Prime Minister said: "The Conservative governments of the Eighties made some good steps forward on choice and competition but didn't understand enough about the public service interest. I think the Blair governments took some good steps on foundation hospitals and academy schools, but they were too tentative."

He added: "It's about saying what worked and what was the consistent pattern that delivered that and then saying how do we take that to the next stage."

Earlier, Mr Cameron unwittingly sparked a controversy by describing the NHS as "second-rate" in a slip of the tongue during a BBC Radio 4 interview. After Labour accused him of insulting doctors, nurses and other NHS workers, he insisted he had meant to say "second best" and pointed out that he immediately corrected himself during the interview.

Urging critics of the Government's approach to "grow up", Mr Cameron argued that financial pressures meant the country could not afford not to press ahead with them. He claimed unions opposing the reforms felt duty bound to resist them even when in their hearts they knew the change was necessary.

The Prime Minister said the proposed changes should not be delayed: "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. These reforms aren't about theory or ideology – they are about people's lives... If not now, then when?"

But Brendan Barber, TUC general secretary, said: "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."