Shadow health secretary Andy Burnham has unveiled further details of his 10 year plan to merge health and social care services.
Addressing a fringe session at the Labour party conference, Mr Burnham argued the move would not require a structural reorganisation.
He told a session in Manchester that this “big idea” of a “national health and care service” would be “at the heart” of his party’s 2015 election manifesto and campaign.
His comments come as reports suggest party leader Ed Miliband may announce an increase in funding growth for the NHS in his speech to the conference on Tuesday.
Mr Burnham told delegates that the NHS would be able to “keep [its] organisations” under a Labour administration while hinting at structural changes
“I listen carefully to what has been said [about the prospect of reorganisation] but that would be a worry if I was asking the system to go in a direction it really did not want to go…Everyone is wanting to do this anyway.
“I am going with the grain unlike [former health secretary Andrew Lansley] who came along and tried to get a system to go to a place it didn’t want to go. That’s the big difference.
“This is clear vision. We did not know what [Mr Lansley] was trying to achieve.
“The system wants to go in this direction and I am saying this is a 10 year journey. I am not saying this is a big bang [or that] it has to be done next year.
“I’m saying you can keep your organisations if you want. You can carry on working for them. But they are going to have to work in a much tighter partnership.”
Mr Burnham also indicated that local government would take a lead in commissioning services under a Labour administration.
He said at the event organised by The Guardian there needed to be a single commissioning organisation at the “local level” which was “led by local government”.
This he said would re-establish “the link between health and education, health and planning, health and leisure, but crucially health and housing”.
He added that Nye Bevan, who spearheaded the formation of the NHS after the Second World War, had been minister for health and housing, and that he wanted to restore that link between the two areas, which “had been broken somewhere along the way”.
Mr Burnham said his ambition would require changes to financial incentives.
He said: “The whole system is not incentivised to spend money in the home.
“The incentive is actually to cut money there, because [local authorities] want to keep the council tax down and hospitals get paid by how many people come through the door.
“The financial tide drags to the expensive end of the system: the hospital.
“And no one there really has got an incentive to break that, because that’s how they get paid.
“It’s only when you can turn that tide around that you can start the simple things come into play.
“This is why we are saying a year of care approach rather than an episodic tariff… where you have an annual budget not just for the medical needs but for the social needs too.”
Experts remained unsure how such ambitions can be achieved without a reorganisation.
Speaking to LGC’s sister title Health Service Journal after the session, King’s Fund assistant director Richard Humphries said: “If you want to achieve whole person care, it’s difficult to see how you do this without reorganisation.
“Andy Burnham seems to want to give commissioning to local government and integrate social care provision into the NHS.
“It is difficult to see this being done without something like a reorganisation.”