David Cameron has defended the proposed NHS changes, arguing that "fundamental changes" are required for the UK to catch up with European health care standards.

"I don't think there is an option of just quietly standing still, staying where we are and putting a bit more money into the NHS," the prime minister told Today presenter John Humphrys.

Hitting back at critics who claim it is not the time for a large scale reform of the health service, the he said the reform "goes with the grain of the best things that have happened in the NHS".

The move would put power in the hands of GPs, "the most trusted people in the NHS".

"Future changes in the National Health Service depend on the choice we make as patients, rather than top-down decisions by bureaucrats sat in Whitehall," Mr Cameron added.

Health inequalities in England and Wales were "worse than at any time since the Victorian times," he said, and GPs "will be able to do more in the poorest parts of our country".

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