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• Prime minister to claim in speech that Conservatives are defenders of the health service • Baroness Williams demands sacking of No 10 adviser Mark Britnell over privatisation remarks David Cameron is to insist that there will be few compromises on the controversial NHS bill while claiming Conservatives are defenders of the health service. Wresting the issue from his health secretary, Andrew Lansley, the prime minister’s speech in west London on Monday will aim to get his party back to where it was in opposition when the Conservatives claimed they could be trusted not to dismantle the NHS if they formed a government. Alluding to his young son Ivan’s dependence on the NHS before his death, Cameron will return to a familiar formulation: “It’s the most important thing to my family. That’s why, over four years ago, I got up on a platform like this and said that you could sum up my priorities in just three letters, N-H-S.” On Saturday, Professor Steve Field, the senior doctor appointed by Cameron to review the government’s health plans, described them as unworkable and “destabilising” . Field is in charge of Cameron’s NHS future forum, set up last month to manage the “listening exercise” to stem public disquiet about their reforms and coalition opposition. Field told the Guardian he rejected Lansley’s plan to compel hospitals to compete for patients and income and felt NHS regulator Monitor should promote cooperation rather than being used to referee competition between providers. Faced with a constant drumbeat of criticism, the prime minister will attempt to reassure critics that his government can tread a fine line between safeguarding and reforming the NHS. His speech closely resembles one given by Ed Miliband last month when the Labour leader said he opposed the government’s reorganisation principles but accepted that the rising costs of healthcare required some kind of reform. Cameron is due to say: “Sticking with the status quo and hoping we can get by with a bit more money is simply not an option. If we stay as we are, the NHS will need £130bn a year by 2015, meaning a potential funding gap of £20bn. The question is, what are we going to do about that: Ignore it? No – because we’d see a crisis of funding in the NHS, overcrowded wards and fewer treatments. Borrow more so we can chuck more money at it? No – because we can’t afford to. Ask people to start paying at the point of delivery for it? No – because the NHS must always be free to those who need it. “There’s only one option we’ve got – and that is to change and modernise the NHS… to make it more efficient and more effective and, above all, more focused on prevention, on health, not just sickness. We save the NHS by changing it.” Cameron will defiantly stick to the reorganisation his government has initiated and appears to back GP consortiums. “Last year, the health select committee said ‘primary care trust commissioning is widely regarded as the weakest link in the English NHS’, citing their ‘lack of clinical knowledge’ in particular. This is what top-down control is doing to our NHS – and I believe it should change. Then there’s the inflexibility of the NHS – and this is what frustrates so many patients, and indeed nurses and doctors.” The Lib Dem peer Lady Williams is calling on Cameron to dismiss his senior adviser Mark Britnell after he told a conference that the NHS could be improved by charging patients and could be transformed into a “state insurance provider, not a state deliverer” of care. His unguarded comments were made in October but only reported this week . Britnell, appointed to a “kitchen cabinet” advising Cameron on reforming the NHS, told executives from the private sector that future reforms would show “no mercy” to the NHS and offer a “big opportunity” to the for-profit sector. No