David Cameron will signal his determination to press ahead with “deep change” in the NHS, warning it faces a fundamental crisis in the future if reforms are blocked.
The prime minister will use a keynote speech to detail some of the reworking being done of the government’s health service shake-up to meet widespread political and professional hostility.
But he will make clear that the controversial package drawn up by Health Secretary Andrew Lansley will not be abandoned as Labour seeks to exploit tensions within the Tory-Lib Dem coalition over the plans.
Speaking at a London hospital, the premier is expected to say: “We save the NHS by changing it. We risk its long-term future by resisting change now.
“I know that some people still have concerns. They might be listening to this and thinking: ‘OK, but if you love the NHS so much, if you don’t want to take any risks with it, why do you want to change it?
“But this is the point: it’s because I love the NHS so much that I want to change it. It needs to change to make it work better today and it needs to change to avoid a crisis tomorrow.”
Mr Cameron’s speech came after a weekend of continued focus on fears among health professionals and patients that the reforms will “destroy essential services”.
Ministers have promised “substantial” changes after buying time by calling a “pause” to the progress of the Health and Social Care Bill pending the results of a “listening exercise” involving patients and health professionals.
The senior doctor leading the urgent review used a newspaper interview to detail a series of concerns highlighted by the process so far - mostly surrounding a push to increase competition.
Professor Steve Field, who chairs the NHS Future Forum, said: “If you had a free market, that would destroy essential services in very big hospitals but also might destroy the services that need to be provided in small hospitals.”
Under the proposals, groups of GPs would be handed control of around £80 billion worth of NHS spending, with a remit to commission treatment and services from “any willing provider” - including private companies.
Labour and other critics warn the changes open the health service to full-blown privatisation - a charge Mr Cameron will again seek to quash in his speech.
Deputy Prime Minister Nick Clegg has vowed to veto the legislation - elements of which are deeply unpopular among Liberal Democrat MPs and activists - as part of efforts to demonstrate a greater influence by his party in the Tory-led government.
Mr Cameron will say that the “raised passions” in the debate over the Bill proved only that the NHS “is the most important thing to Britain’s families” and that he was right to make it his top priority.
“We have an institution - a precious idea - that says we are in this together; looking out for each other. So this government will never, ever take risks with the NHS. We will make it better,” he is expected to tell his audience.
“I’ll say it again: I love the NHS. But I’m sorry, I just do not think we do anyone any favours, not the patients who use our health service, the professionals who work in it or the taxpayers who pay for it, if we deny that there are problems with the way the NHS works today.”
He will say that the “resounding message” from the patients, doctors and nurses he had met during the listening exercise was: “Yes, we love the NHS but yes, there are some real problems.”
There was waste and inefficiency, too much “top-down control”, inflexibility, a lack of co-ordination and wide disparities of quality of service and of health outcomes in different parts of the country.
“Sticking with the status quo and hoping we can get by with a bit more money is simply not an option. If we stay as we are, the NHS will need £130 billion a year by 2015 - meaning a potential funding gap of £20 billion.”