Former health secretary Stephen Dorrell told a debate at the Kings Fund think tank in London that a fundamental shift in thinking was required to meet the country's changing economic situation and healthcare needs.
He said these two issues had to be 'dramatised' and kept 'stage centre' to ensure that action was finally taken to create properly integrated services after decades of discussion.
'This is a burning platform. If the system does not change in the way that's been advocated for years, it will run out of money and vulnerable people will get hurt.
'There is an urgency to address the requirement for change because the only way of meeting demand on the system is a fundamental re-imagining of what the services need to look like within the cash envelope that's going to be available.'
Mr Dorrell said that as well as the economic argument for change, the type and quality of care delivered by the existing system did not fit the needs of the population.
He said the current system was designed to deliver a transaction around an episode of care to normally healthy people – but nowadays people were more likely to need lifelong care with occasional medical interventions.
The answer, said Mr Dorrell, was a system designed with its central purpose being the delivery of care, supported by a ‘medical adjunct.’
He had a stark warning for commissioners who did not take on the challenge.
‘If the commissioning system does not accept responsibility for the re-imagining process that’s necessary, then it’s not entirely clear to me why we pay their salaries.’