The Health Secretary has vowed to take on the left and the right to reform the health of the nation, warning that the nation’s economic prosperity is at risk without change.

But Wes Streeting insisted that he would make changes “with people” and not “to people” when asked about nanny state concerns, saying he is not the “fun police”.

He said that sticking plasters “won’t cut it” and said the Government was going to make “big changes”.

Speaking at an event for the Institute for Public Policy Research (IPPR), Mr Streeting said he expects “loud opposition” to reform.

But he warned of a “rising tide of pressure” facing the NHS and highlighted a report of the IPPR’s Commission on Health and Prosperity, which concluded that Britain is the “sick man of Europe” when it comes to health.

“If we don’t act now, ever-increasing demands for healthcare threaten to overwhelm and bankrupt the NHS,” he said.

“Our sick society is also holding back our economy.”

He highlighted how a drop in productivity due to ill health “has cost our economy £25 billion since 2018” and how 900,000 more people are off work than would have been on pre-pandemic trends.

To build a healthy economy, we need a healthier society. To achieve that, we need reform of the health service, and public health reform, too

“That’s more people than Tesco, Sainsbury’s and Asda employ put together,” Mr Streeting said.

“Fail to act and by the end of this parliament, 4.3 million people could be off work sick. Millions of people left behind, the welfare bill will balloon, and growth will be hampered.

“To build a healthy economy, we need a healthier society.

“To achieve that, we need reform of the health service and public health reform, too.”

The IPPR Commission is co-chaired by Lord Darzi – who recently led a hard-hitting review into the state of the NHS for the Government – and England’s former chief medical officer, Professor Dame Sally Davies.

Lord Darzi’s report, published last week, concluded that the NHS is “in serious trouble” and has prompted Labour to promise widespread reform of the health service.

Mr Streeting added: “The great thing about the Darzi report – it is not a left-wing or a right-wing view of the NHS. It told hard truths to both sides of the debate.

“And it forces me to now take on both left and right-wing orthodoxies.

“The lesson from the Darzi report is clear- the Tories did neither; this government has got to do both.

It really is reform or die, and we choose reform

“Unless we do public health reform, the right will have to accept higher costs for healthcare, paid for by higher taxes. I don’t think that’s a price working people can afford to pay.

“The left has to accept health service reform, or there will be no health service. At least not as we currently recognise it.

“Reform always has opponents, often vocal and powerful opponents. The Prime Minister and I will face down that opposition because it is in the interest of patients, the health service, and taxpayers in this country.

“It really is reform or die, and we choose reform.”

Mr Streeting said that the Government would set out its plans for reform in the early part of next year which will deliver “three big shifts in the focus of the NHS: from analogue to digital, hospital to community and sickness to prevention”.

Asked about “nanny state” concerns over reform, Mr Streeting said: “I have not banned cake in the Department of Health.

“In fact, I was at NHS England the other day and saw an abundance of sugary treats – I have not reported them to the Chief Medical Officer yet.

I'm really not interested in being the fun police or telling people how to live their lives, and people certainly won't have to worry about closing their curtains at night in case I'm peering through the window and looking at what they're eating, drinking or smoking

“I’m really not interested in being the fun police or telling people how to live their lives, and people certainly won’t have to worry about closing their curtains at night in case I’m peering through the window and looking at what they’re eating, drinking or smoking.

“We do take this issue of chronic disease seriously and the impact is having on our lives – our life expectancy, our ability to live our lives to the fullest extent for the longest time possible.

“I think we are in this appalling situation when we are living longer, but becoming sick sooner – that’s terrible for the quality of life, it’s also terrible for the economy, for the labour market and for the financial sustainability of our health and care services.

“So when it comes to having some cake or going down the pub, everything in moderation.

“And crucially, when it comes to measures we are considering, especially where this involves legislation, I don’t believe in doing things to people, I believe in doing things with people – we want to change the national conversation about our health and our wellbeing and the types of reforms that we might want to see.

“Smoking is at the easier end of the spectrum frankly, it is still the biggest killer. It is uniquely harmful, it is uniquely addictive and there are unquestionably harms that occur through second-hand smoking and passive smoking, we’ve got to take that seriously,

“But we’re going to consult, we’re going to engage and we are going to enjoy the national debate in the process.”

Mr Streeting also said that concerns over maternity care keep him awake at night.

He said: “When it comes to the crisis in our maternity services across the country, it is one of the biggest issues that keeps me awake at night worrying about the quality of care being delivered today at the risk of disaster greeting women in labour tomorrow.

“I think that what we have seen, in the case of specific trusts, are problems and risk factors that exist right across maternity services across the country.

“And we’re keen to make sure that when it comes to the work that Donna Ockenden has already done, we make sure that those lessons are applied, not just in the case of those specific trusts, actually right across the country.

“We are determined to get this right.”