Jeremy Hunt has renewed his criticism of NHS care and culture by warning that the service's tolerance of "mediocrity" could result in another Mid Staffs scandal.
The health secretary attacked what he said was hospitals' reluctance to drive up the standard of care they provide and refusal to seek patients' views on their treatment.
Hunt risked alienating NHS staff with another strongly worded denunciation of the service, saying too many hospitals represented "a garden of mediocrity", with the resulting "weeds" putting patients at risk of neglect, as at Stafford hospital. The service should be seeking "universal excellence" to match the universal access it provided, he argued.
"The NHS was set up 65 years ago not just to deliver universal equity, but universal excellence. It has been much better at delivering the former than the latter – but if it is to live up to its founding ideas it needs to deliver both," Hunt told a gathering of NHS leaders.
"So my question today is this: we celebrate excellence, we criticise failure, but do we do enough to challenge mediocrity? Because left unchallenged, it becomes entrenched, part of the culture.
"And that is precisely the moment of greatest danger if we are to prevent the next Mid Staffs. The weeds of failure grow more quickly in a garden of mediocrity."
He lauded the NHS for making the UK the best place in the world to be ill for the poor and socially disadvantaged and for having "enriched" last year's Olympic Games through Danny Boyle's celebration of the service in the event's opening ceremony – a feature which Hunt reputedly tried to have removed or watered down when told about it in advance, when he was still the culture secretary.
But without every part of the NHS pursuing excellence, the Mid Staffs public inquiry chairman, Robert Francis QC's call for a radical overhaul of how it works and its attitude to patients would not be fulfilled, Hunt said.
"Unless we create a climate of excellence in the parts of the NHS that are neither good nor bad, we will fail to address the cultural challenge that Robert Francis describes."
He said striving for routine excellence must be a key part of how the NHS responded to Francis's landmark report last month on how between 400 and 1,200 patients died at Stafford hospital because of poor care between 2005 and 2009.
In a speech to a conference organised by the Nuffield Trust health thinktank to debate the future of healthcare, the health secretary warned the service's leaders that simply delivering minimum standards was not enough.
"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then suddenly, something gives," Hunt said.
Labour dismissed Hunt's criticisms of the NHS as "rhetoric" and accused him of endangering patient care by letting hospital trusts shed staff, especially nurses, as part of the service's £20bn efficiency drive.
"Today's rhetoric means nothing when it's already clear that Hunt isn't learning from Mid Staffordshire's terrible mistakes," said Jamie Reed, the shadow health minister. "Patients are paying the price as the government cuts the number of nursing jobs. Ministers are running the very real risk of more care failings. Four thousand nursing jobs have already been lost under this government.
"If Hunt fails to stem the losses, at the current rate, 12,000 will go by 2015."
Mike Farrar, chief executive of the NHS Confederation, said hospitals needed to provide more information about the performance of the services they provide and had a crucial opportunity to undertake a "culture change" like that recommended by Francis.
But Hunt was right to say that every NHS organisation "should aspire to be world-class", added Farrar.