Lib Dem leader Nick Clegg has launched an attack on the way the NHS is run, describing it as a service in "crisis".
In his first major television interview since becoming leader, Mr Clegg said: "It is one of the most unequal health services in the modern world."
He told the BBC he would hand control of the NHS to local people.
He also predicted Gordon Brown would suffer his first Parliamentary defeat over 42 day terror detention, which MPs will debate next week.
The Lib Dems would introduce locally elected health boards, Mr Clegg told the Andrew Marr show, and if patients' needs were not met they would be able to have private treatment paid for by the NHS.
The party would also scrap centralised targets and give people the power to raise cash for health services through a local income tax.
"If you are going to give local communities more say over health services, they should also be able to vary, maybe raise extra money," said the Lib Dem leader.
He said the "great crisis" in the NHS is that after 10 years of "unprecedented" spending, it was full of inequalities because of the centralised "top down" way in which it is managed.
"If only the National Health Service was a national health service.
"It is one of the most unequal health services in the modern world.
"In Sheffield, the city where I'm an MP, if you are a child born in the poorest ward in Sheffield, you will die, today in 2008, 14 years before a child born five miles down the road in the wealthiest ward and the Health Service, the National Health Service, isn't providing equitable outcome.
"It is failing those people who need it most."
Turning to government plans to extend detention of terror suspects without charge, Mr Clegg said his party would join forces with the Conservatives in the Lords to defeat them.
He said the plans were flawed, as they were based on anticipating a likely future need for longer detention periods.
"You cannot in my view, ask Parliament to legislate hypothetically when there is no evidence that you really need to do so," said the Lib Dem leader.
"There are so many other alternatives where all parties could work together."
Mr Clegg refused to be drawn on whether he would form a coalition with Labour or the Conservatives in the event of a hung Parliament.
He also denied he had taken his party to the right, saying such arguments were out of date.
And he called on Prime Minister Gordon Brown and Conservative leader David Cameron to work with him to fix Britain's "clapped out" political system and restore trust.
"The politics of the past is for parties to gang up against each other, the politics of the future is for all parties to agree together how we renew politics," he told Sunday AM.