He said the coalition would continue to increase spending on health in real terms, but that the NHS still needed to be overhauled.
“We don’t get the results we should compared with other European countries; if we did we would save thousands of lives,” he told the Andrew Marr Show.
Health unions have hit out at the plans, due to be debated by MPs today.
The Health and Social Care Bill, published earlier this month, will see consortia of GPs control of most of the NHS budget from 2013, with responsibility for “buying in” the bulk of hospital services for their patients.
All 151 primary care trusts and strategic health authorities will be disbanded under the plans.
Lansley (pictured) said: “I didn’t say there wasn’t risk. Of course there’s risk because there’s change. But actually if we don’t change, the greater risk is that these problems that we have at the moment that we have to deal with won’t be solved.”
The reforms would result in a redundancy bill of £1bn, he said, but savings would reach £5bn over the course of the parliament.