The health secretary Patricia Hewitt told clinicians that they must lead reconfiguration in the NHS.
NHS reform will only work if it is led and driven by clinicians, she told a conference of the Royal College of Surgeons of England (RCSE).
Past experience has taught the government that reforms suffer when it attempts to drive against clinician opinion, Ms Hewitt acknowledged, telling her audience: "If you do feel marginalised I want to know about it."
The health secretary was attempting to justify the government's plans to centralise services, amidst widespread criticism of supposed cuts to local services.
Ms Hewitt explained that changes in medicine and surgery are driving NHS change, rather than any national reconfiguration plan.
"Because medicine and surgery are changing so dramatically the NHS has to change too," she said. "This is about ensuring appropriate facilities. Local where possible; centralised where this is necessary,"
Planned reforms will lead to better patient care and ultimately save more lives, Ms Hewitt argued.
Speaking after the conference, Ms Hewitt said clinical leadership would be essential in shaping proposals and communication reforms to the public.
The health secretary addressed the RCSE, as the Royal College of Nursing (RCN) raised concerns that student nurses are frequently left unattended with patients.
A RCN survey found 44 per cent of students had been left unattended, in breach of government guidelines.
RCN general secretary Peter Carter argues NHS financial cuts are to blame, citing staff shortages, employment freezes leading to unemployed graduates, and overstretched and under resourced registered nurses.
"Patient safety is of paramount importance to the government and NHS staff alike," the Department of Health (DoH) maintained. "We would expect any nurse, whether in training or in practice, to report any incident they feel has an adverse effect on patient safety," health minister Lord Hunt added.
Since 1997, the DoH has recruited around 85,000 more nurses and "record numbers" now deliver NHS care every year, the government said.