Shadow health secretary Andrew Lansley attacked Alan Johnson in a speech to the Royal Society for Arts yesterday, accusing him of neglecting his responsibilities as health secretary.

Alan Johnson’s recent comments on the need for electoral reform have led to speculation that he covets the Labour leadership. Mr Lansley said: “Instead of driving through key reforms in the NHS, Alan Johnson’s been eyeing up another job. And the NHS is suffering as a result. It’s incredibly frustrating.”

He said Mr Johnson’s “lack of progress” on the reforms introduced by former prime minister Tony Blair and former health secretary Alan Milburn were “doing real harm to our NHS”.

He said Mr Johnson and prime minister Gordon Brown had neglected or stalled progress on the four Blairite drivers of reform in the NHS, which the Conservatives had supported. The primary care strategy published last year had created newspaper headlines that people would be able to choose their GP, he said. “But when you looked at the detail, it rang hollow,” as GPs would still have fixed practice boundaries.

Choice of hospital had also stalled, with only 46 per cent of patients experiencing choice. This stalling of the choice agenda was aided by the government rolling back on its earlier commitment to open up the NHS to competition. The extension of the independent sector treatment centres programme had been cancelled and the policy behind it “went into reverse” as the health secretary had said private sector involvement was primarily about providing extra capacity, not competition.

Practice based commissioning was in effect “pointless”, Mr Lansley claimed, as GPs held only notional rather than the real cash budgets a Conservative government would give them. GPs were also unable to reinvest savings or negotiate and hold contracts. That undermined a key driver of reform as GPs had the power to force hospitals to improve standards by refusing to refer patients to poor performers.

The fourth driver – foundation trusts – had also stalled, he claimed, with the government missing its own 2008 target for all acute trusts to become foundations.

Mr Lansley warned that life under a Conservative government “won’t be easy” for the NHS, and pointed out that NHS chief executive David Nicholson had already said efficiency savings would need to reach up to £20bn by 2014. In addition to this, demands on the NHS would increase, with the ageing population and increasing life expectancies of people with chronic diseases.

“The NHS cannot successfully respond to this unless we root out waste. Unless we get rid of the underlying inefficiencies that mean patients do not always get the treatment they deserve.”

But he said a Conservative government would ask the public to take more responsibility for lifestyle choices that create unsustainable demands on the NHS.

“All of us need to face up to what’s behind so much of the demand on the NHS, and start to take responsibility for improving such things as our diet, activity levels and alcohol use,” Mr Lansley said.

But he said a focus on personal responsibility would not be at the expense of the equity of a tax funded universal system. “There is no greater expression of collective responsibility, of our duty to our fellow citizens, than the NHS. Collectively we are committed to pay for, look after, and care for the frail and the sick in our society, regardless of their circumstances. That is something of which I think we should all be proud. I am determined that future generations will also be supported by the NHS.”