The United Kingdom cannot afford to delay far-reaching public-sector reforms, Prime Minister David Cameron said Monday. In a speech to the Royal Society of Arts in London he said that “pretending that there is some easy option, of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges, is a complete fiction.”

The coalition government in Britain does not intend to privatize health-care services. The public health system was actually the only department besides foreign aid to be excluded from the rigorous spending cuts that Cameron enacted last year. Critics who allege that his plans amount to privatization need to “grow up,” the prime minister said.

Instead the government will introduce legislation that would allow consortiums of doctors to take over management of the National Health Service (NHS) from primary care trusts in England.

The measure is part of a broader reform effort on the part of Cameron’s government, aimed at empowering citizens and restoring their sense of individual responsibility.

Before the Conservatives came to power in coalition with the centrist Liberal Democrats, Britain’s budget deficit amounted to 12 percent of GDP, or £163 billion. The national debt had reached a record high of £857 billion.

During the preceding thirteen years of Labour rule, health care and education spending more than doubled while tax rates remained almost unchanged. More than 20 percent of the country’s workforce is now employed by the government. Almost 30 percent of public spending is devoured by an enormously complicated and complex welfare regime which still leaves many in financial despair. Nearly four of Britain’s twenty million households have no one who earns a wage.

Cameron believes that this pervasiveness of the British state in people’s lives has deprived them of their sense of personal responsibility. His “Big Society” initiative is designed to counter the trend. “We believe that when people are given the freedom to take responsibility, they start achieving things on their own and they’re possessed with a new dynamism,” he professed last year.

Even if the health reform measure currently under review would seem relatively modest, six of Britain’s largest health unions have nevertheless expressed “extreme concerns” about future competition between the NHS and private health providers. The British Medical Association, the Royal College of General Practitioners and trade unions believe that the upheaval is unnecessary.