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For fifty or more years the NHS has been part and parcel of what it means to be British.

For the Government the ideal of the NHS, the way it is funded, remains good today.

We make that case not out of nostalgia, though we are deeply proud of the NHS; not out of dogma, because we have looked at alternative systems and rejected them, but out of conviction: that to make employers and workers pay for healthcare as in France or Germany, or to leave it to the market as in the United States are all recipes for an unfair system and too great a burden on British families and businesses. We should be proud that in Britain we have a fair and efficient model of healthcare.

In the Budget, and confirmed in the spending review, we demonstrated our commitment to the NHS with sustained investment. The NHS budget will grow by one half in cash terms and by one third in real terms over just five years. Decades of under-investment and run-down services are at last being reversed.

By delivering the largest ever sustained increase in NHS funding, the Government has moved the debate from resources to reform. For too long lack of money became an excuse for lack of modernisation. There is now a much wider understanding that the problems of the NHS are more than financial. And now, with the funding issue settled for the next few years, the NHS can address the need to reform itself - from top to toe - to meet the challenges of rising patient expectations.

Over the past four months, specialist teams involving front-line staff, professional groups, patient representatives - alongside senior doctors, nurses and managers - have been helping to prepare this NHS Plan. We have heard from both patients and the public. I am grateful to all of them for their personal contribution to reforming the NHS.

At its heart the problem for today's NHS is that it is not sufficiently designed around the convenience and concerns of the patient. The NHS provides many patients with a good and reliable service. But it is simply not responsive enough to their needs. Patients have to wait too long for treatment. Records get lost. Wards are not clean. Standards are too variable. Old-fashioned demarcations between staff, restricted opening and operating times, outdated systems, unnecessarily complex procedures and a lack of training all combine to create a culture where the convenience of the patient can come a poor second to the convenience of the system.

This is not because staff are lazy or uncaring. Quite the reverse. NHS staff are the biggest asset the health service has. Overwhelmingly they do a brilliant job. But they feel as frustrated with the system as patients do. They have to fight the failings in the system rather than being able to harness its strengths. This is because the NHS is a 1940s system operating in a twenty first century world.

This NHS Plan sets out the steps we now need to take to transform the health service so that it is redesigned around the needs of patients. It means tackling the toughest issues that have been ducked for too long.

For the first time there will be a system of inspection and accountability for all parts of the NHS. The principle will be national standards combined with far greater local autonomy, with new money to reward good performance.

For the first time there will be a consultant contract that gives most money to the doctors working hardest in the NHS.

For the first time nurses and other health professionals will be given the bigger roles that their qualifications and expertise deserve.

For the first time local health services and local social services will be brought closer together in one organisation.

For the first time the NHS and the private sector will work more closely together not just to build new hospitals but to provide NHS patients with the operations they need.

For the first time patients will have an advocate in every hospital, so that a system designed around patients is a system with more power for patients.

These major reforms, we believe, will deliver real benefits for NHS patients: less waiting; faster, more convenient care; improvements in elderly care services and for the top priorities of cancer, heart disease and mental health; visible improvements in the basics of cleaning and food and a new focus on prevention and tackling health inequalities.

None of this can be done without many more professionals - and it takes time to train and recruit these staff. Stage by stage - not all at once - patients will see the benefits of these reforms. The timetable and outputs we expect are set out in the National Plan. Expanding and reforming the NHS takes time. Change of this nature and on this scale cannot happen overnight. Others will take time. This is a ten year Plan for reform. But over the next few years patients will see major improvements in their local health services.

This is a once in a lifetime opportunity to bring about the most fundamental and far-reaching reforms the NHS has seen since it was created. This Plan has helped forge a new national alliance behind a modernised NHS.

Reform is backed by large and sustained levels of funding and a Government with the will to see change through.

It is backed by a new consensus in the NHS amongst all the leading health organisations, that this is the best chance for reform.

Over the next few years all of us - the alliance that has come together to build this Plan - must put our energies now into delivering the Plan, so that each year the new milestones are met. Each year, patients will begin to see a new NHS unfolding, growing and getting better, more convenient with less waiting for themselves and their families.

Like key stakeholders, the Government is committed to the NHS core principles set out at the begining of this Plan. Together with all those who share our vision, we will work day in and day out to make it happen.

The Rt Hon. Alan Milburn MP
Secretary of State for Health