Just as surely as that ethos of public service makes the NHS, losing it would break the NHS

Alan Milburn

He said that the role of the private sector in the NHS will be limited to work at the margins.

He explicitly rejected the philosophy of "private sector good, public sector bad", which some unions have accused the government of adopting.

And he stressed the government wants a new relationship with the private sector - not a takeover.

Ethos

He said: "Just as surely as that ethos of public service makes the NHS, losing it would break the NHS. We risk the ethos of the NHS - its values and its principles - at our peril.

"This is not privatisation as some would seek to categorise it, the taking of services out of the NHS.

"It is bringing into the NHS private sector help in those areas where it has a track record, and where there are clear benefits for patients.

"The private sector will help, but the NHS is, and will remain Britain's dominant healthcare provider."

Mr Milburn also said it would be "folly" to sacrifice the values and principles of the NHS and, to specifically reject any move towards an American-style system based on private healthcare insurance.

"You only have to look across the Atlantic to see what happens when frontline health care is compromised by a clash of motives."

Specific targets

Alan Milburn wants private sector involvement in the NHS

However, he also warned that NHS staff should not "close their minds" to co-operation with the private sector.

The government has set out four specific areas where the private sector can become involved.

Two are using spare private sector capacity for operations on NHS patients, and allowing private sector management to run stand-alone surgery centres.

It would also extend the private finance initiative to primary health care, social services and the provision of equipment, and use private sector expertise in areas like information technology.

Earlier, Mr Milburn told the BBC's Today programme that he was keen to give frontline staff more power.

"The money is going in but we have got to get the reforms in as well.

"And that crucially in my view means we have got to get the money and the power down to the front line staff, down to the managers and the doctors and the nurses and all the other staff who do such a brilliant job, so that they can decide how to spent it for the benefit of patients rather than me deciding it in Westminster."

More freedom

Health service managers are calling on ministers to give them more freedom to carry out the government's modernisation plans.

The NHS Confederation says changes are being hampered by political interference.

It says managers want to be given the freedom to compete on equal terms with the private sector to run public services.

They complain that the many targets and instructions handed down from Whitehall have overwhelmed those trying to run hospitals and primary care trusts.