Conservative leader David Cameron has pledged that a Conservative government would increase spending on the NHS and scrap 'politically driven central targets'. And he promised it would not push through further reorganisations.

In his first speech as leader to the NHS Confederation conference, Mr Cameron said he wanted to see 'evolution, not revolution'.

He set out 'four progressive stages': committing increasing resources to the NHS; devolving power and responsibility to the front line; 'setting the NHS free from political interference in day-to-day management'; and the 'transformation of the Department of Health into the Department of Public Health'.

He said the Conservatives' creation of an internal market in the 1990s was not perfect but was now universally accepted, adding: 'We have a duty not to subject the NHS to further unnecessary reorganisation.'

He pledged that a Conservative government would increase spending on the NHS year on year. Any reduction in acute care would be 'matched by the spending on social care and long-term healthcare that longer lives and good health demands'.

Rock bottom morale

Mr Cameron cited the survey of managers and clinicians in last week's HSJ, which he said shows 'morale is now rock bottom throughout the NHS'.

He promised a new national watchdog to 'monitor NHS services and act as a champion for patients'.

Accountability would be better served by an independent board for the NHS, he said, 'composed of professional clinicians, managers and senior executives'.

'Ministers, accountable to Parliament, will be responsible for the overall framework of the NHS,' he said.

Once the NHS had 'the money it needs, patients and professionals are properly in charge, and when the independence of the NHS is guaranteed', the role of the DoH should change to focus more on public health.

Plymouth primary care trust chief executive John Richards said: 'I think there is little to disagree with. We welcome a commitment to building on things they recognise as having worked, and the emphasis on public health.'

But one mental health trust non-executive director, who did not want to be named, said: 'It was current policy under a different spin. A lot of what was said is already happening.'