NHS change is needed, says David Cameron

David Cameron has said “fundamental changes” are needed in the NHS and a “quiet life” was not an option.Defending reforms for England, he told the BBC it was right to start now and change was being done “steadily” – amid criticism it is being done too fast.He will set out his determination to modernise Britain’s public services in a speech later.The Royal College of GPs, the British Medical Association and trade unions say the upheaval is unnecessary.Ministers will publish a health bill this week that will pave the way for GP consortiums to take over management of the NHS from primary care trusts.But the Royal College of GPs and the British Medical Association say the same results could have been achieved by a small change in the current structure.At the same time, the heads of six health unions, including the BMA, have warned in the Times of their “extreme concerns” about greater commercial competition between the NHS and private companies.In his speech Mr Cameron will praise news that 140 GP groups have come forward to take on the new commissioning powers ahead of their introduction across England in 2013.

He told BBC Radio 4’s Today programme doctors were helping drive the pace of reforms: “We’ve got GPs coming forward in 140 consortia to take on the task – the GPs coming forward cover about half the country so there’s a lot of enthusiasm for what we are doing.”He said the change was not about saving money but about getting a “healthier nation” – although he said bureaucracy would be introduced and the change would make “net savings” within two years.He argued there was nothing in the reforms that had not been tried out in some way before and said it was “not being introduced in one great big bang” – some reforms would not come in until 2015.Mr Cameron said: “In an NHS where at the moment drugs bills are going up, new treatments are being introduced, the population is ageing, extra costs are being introduced, there isn’t a quiet-life option.”I think if we just carried on as we are, because there is so little incentive in the NHS to actually improve the health of the nation, I think we would face a very big crunch in two or three years’ time.””It is necessary because we’ve fallen behind the rest of Europe, we spend similar amounts of money but we are more likely to die of cancer or heart disease – I don’t think we should put up with… coming second best, we should aim to be the best.”He added: “I don’t think there is an option of just quietly standing still, staying where we are and putting a bit more money into the NHS. I think we do need to make more fundamental changes.”

In his speech Mr Cameron will say that even after the cuts are complete, public spending will still take up 41% of national income – the same level as in 2006.And he will say that at £5,000 per pupil, spending on education will be the same as in Germany and more than in France; London will have as many police officers as New York; and health spending will match the European average.”It’s just not true to say that the spending taps are being turned off,” Mr Cameron will argue.He will also try to shake off claims by Labour that his reform agenda is driven by the wish to save money and an ideological desire to reduce the size of the state.”My passion about this is both personal and political,” he will say.”Personal because I’ve experienced first-hand how dedicated, how professional, how compassionate our best public servants are.”The doctors who cared for my eldest son, the maternity nurses who welcomed my youngest daughter into the world, the teachers who are currently inspiring my children, all of them have touched my life, and the life of my family, in an extraordinary way and I want to do right by them.”And this is a political passion – and priority – of mine too.””These reforms aren’t about theory or ideology – they are about people’s lives – BBC