³ÉÈË¿ìÊÖ

Health Secretary Andrew Lansley has admitted there is "risk" involved in his English NHS shake-up but says there is a greater risk from doing nothing.

He said spending was set to rise, but the Labour years had shown that spending more money "isn't the answer".

"We don't get the results we should compared with other European countries; if we did we would save thousands of lives," he told the Andrew Marr Show.

Health unions have denounced the plans, due to be debated by MPs on Monday.

The Health and Social Care Bill, published earlier this month, will allow GPs to get control of most of the NHS budget from 2013 - working in consortiums and taking on responsibility for "buying in" the bulk of hospital and community services for their patients.

In the process, all 151 primary care trusts and strategic health authorities will be disbanded.

In the lead up to the bill's publication, fears were voiced that hospitals could go bust as the plans include opening up the NHS to "any willing provider".

Critics have also questioned whether GPs have the experience and skills to handle such huge budgets - they will have control of about 80% of the NHS budget.

The timing has also been questioned, as the health service is being asked to save money in coming years.

Speaking to the ³ÉÈË¿ìÊÖ's Andrew Marr Show, Mr Lansley said: "I didn't say there wasn't risk. Of course there's risk because there's change.

"But actually if we don't change, the greater risk is that these problems that we have at the moment that we have to deal with won't be solved."

The reforms would result in a redundancy bill of £1bn, he said, but savings would reach £5bn over the course of the parliament.

He said about half of existing Primary Care Trust staff would be employed by the new GP consortiums.

Asked about the speed of the planned changes and the opposition to them, Mr Lansley said the shake-up - not detailed in the coalition agreement - had been developed within a few weeks of them entering government.

He said most patients would not know much about the current system which, he said, requires 50,000 administrators: "How many patients have actually been treated directly by a Primary Care Trust?"

He said that GPs already made most decisions about the care of patients in the community while hospitals "provide most of the secondary care and tertiary care to patients - I'm not interfering with them. I'm giving them greater freedom on both sides of that equation".

Mr Lansley said he was going to get rid of Labour "rigging" of competition within the health service which had favoured private sector firms.

"They stopped NHS foundation trusts bidding for that capacity. I actually do believe in competition."

So far, 141 GP consortia, serving more than half of the population of England, have signed up as "pathfinders" to pilot the new arrangements ahead of their planned implementation in 2013.

During exchanges at prime minister's questions earlier this month, David Cameron was accused of being "arrogant" for going ahead with the moves despite warnings from unions and health experts.

Labour leader Ed Miliband said medical staff had warned of "potentially disastrous" consequences for the health service.

But the prime minister said the government was "reforming the NHS so that we have got the best in Europe". MPs are set to debate the proposals in detail for the first time from about 1530 GMT on Monday.

The changes were first set out in a white paper published last summer. They apply solely to England - Scotland, Wales and Northern Ireland have different systems..