Outgoing NHS England chief executive Sir David Nicholson launched a sustained attack on the political debate around the health service in his farewell speech to the NHS Confederation.

Speaking this evening in Liverpool at the confederation’s annual conference, Sir David said he was “incensed” at those who had criticised GPs, argued for the need to get away from the “tyranny of the electoral cycle”, and said the government “wasted” two years restructuring the NHS instead of addressing the need to transform services.

Sir David said: “I feel that, over the last few months, it’s as though a wheel has been spun every so often… ‘let’s all attack nurses’, or it’s spun another week and it’s, ‘let’s have a go at general practitioners’…

“I was particularly incensed about some of the coverage in relation to general practice,” he added.

Sir David paid tribute to the quality of primary care services he sees around the country, and praised the GPs who have stepped up to lead clinical commissioning groups as the NHS goes through its “most difficult days”.

Later in the speech he told delegates that normally, the first two years of a Parliament are spent enacting reform, and “you then get to the period before the election where it’s, ‘let’s batten down the hatches’”.

The difference during the 2010 election campaign, he said, was that politicians “went round the country making promises of no change”. He made explicit reference to moratoria on hospital reconfigurations, which had been promised by former health secretary Andrew Lansley before he took office.

“We said at the time it was not the right thing to do – so what happened when we got a new government in, we wasted those two years where you can really make change happen.”

“We spent that time talking about reorganisation. We didn’t talk about the really important changes that were required for the NHS.”

He also said that the first two years of the current Parliament had been “wasted” talking about organisational reform rather than service transformation.

Sir David argued that the reason NHS England was set up was to look ahead and think strategically about the future of the NHS.

This would get the NHS and “out of the tyranny of that electoral cycle, to think about the NHS over the medium to long-term”.

Producing a strategy for the future direction of the NHS was “the reason we were set up”, Sir David said.

The strategy would not take the form of a “great big tome”, but would be produced through a “big conversation”.

“I find it extraordinary that people will argue that actually you don’t need a strategy, that you don’t need to understand where you are going to. 

“If you can’t get alignment about the direction you are going in, I think that is a recipe for managed decline for the NHS over the next few years.  So those people who would say, you don’t need a strategy, you don’t need to do this work, I think their alternative is managed decline.”