Labour councils across England will act as the "last line of defence" against the controversial health act, Ed Miliband said as he pledged to overturn its "free market, free-for-all principles".
Speaking at the launch of the Labour local election campaign in Birmingham, Miliband said Labour councils would use the public health and well-being boards to resist the most damaging aspects of the Health and Social Care Act.
The Labour leader spoke out against the act a week after it was formally granted royal assent by the Queen following a bruising parliamentary battle.
Miliband said Labour would repeal the act if it returned to government after its 11th hour failure to delay the measure in parliament. He said Labour would abide by the law, but made clear the party would do everything within the law to undermine the reforms, which will hand around 60% of the NHS's £100bn budget to GP-led commissioning groups.
The Labour leader said: "I think that Labour councils are now the last line of defence against this bill and they have got to use the public health and well-being boards as a way of trying to prevent the worst aspects of this bill. Of course, comply with legislation because the legislation has passed. But I think there is an opportunity for Labour councils to stand up for the right principles not the wrong principles in our NHS."
Miliband's remarks indicate that Labour believes the boards represent a chance to challenge the implementation of the bill at a local level. The boards will include local councillors, elected mayors and members of the clinical commissioning groups.
Liz Kendall, the shadow social care minister, outlined Labour tactics in a recent article for the Health Service Journal. She argued that the boards can pledge to work in a collaborative way to mitigate the impact of the act by, for example, agreeing to work against the introduction of a postcode lottery.
The powers of boards are, however, limited. They do not have a formal say over clinical commissioning groups and do not have the power to sign off their decisions.
Miliband pledged that a Labour government would repeal the act. "We will repeal the free market, free-for-all principles in this bill. That is an absolute commitment. It is incredibly damaging to the whole ethos of our NHS. Frankly, doctors and nurses and people right across this country know that."
The Labour party used the launch of its local election campaign to announce a focus on restorative justice. Miliband criticised the coalition government for abandoning anti-social behaviour orders, or asbos, as, he said, some criminals should be encouraged to make a greater contribution to their communities.
"Instead of just giving people a caution knowing they will commit further offences, those who do the wrong thing should be forced to make it up to the victim. Make good on the damage they have caused, help rebuild the community project, clean up the graffiti, fix a wrecked garden.
"Of course, it won't be appropriate in all circumstances and should only happen if the victim wants it to happen.
"When offenders have to confront the consequences of their crimes and meet their victims, they can come to understand what they have done and the damage they have caused. This has made some less likely to commit further offences: it puts them back on to the right path."
Miliband faced a series of questions, some pointed, from Labour party members in the Birmingham Selly Oak constituency. But he showed the skills which won him the Labour leadership in 2010; answering everyone by addressing them by their first name and asking for further explanations from those who asked the most difficult questions.
The Labour leader declined to be drawn on his party's failure to win the Bradford West by-election last week when George Galloway, the leading figure in the Respect party, swept back into parliament.
"Labour lost very badly two years ago." he said. "We had our second worst election since universal suffrage was introduced. So we have a long way to come back. I think we are making progress in being an effective opposition and setting out the alternative we are. But I am not in the commentary business. I am in the making a difference business. That is what these local elections are about. It is about saying this is a difference Labour would make."
