NHS boss warns of four hard years ahead after health service gets less cash than requested

The head of the NHS has warned of four hard years ahead for the health service – dismissing ministers’ claims that it has been given all the money it needs.

Simon Stevens warned that much of a promised extra £10bn each year has been “back-ended to 2020”, which means promised improvements would be delayed and tough choices inevitable in the interim.

Speaking to an inquiry by MPs – days after hospital bosses broke cover to argue the NHS will reach breaking point without more money – Mr Stevens admitted to the looming funding shortfall.

The chief executive of NHS England warned: “In the intermediate years, we have got a bigger hill to climb than we first envisaged … there will be controversies along the way.”

The statement will severely embarrass ministers who have repeatedly dismissed warnings of a crisis on the basis that the NHS has been “given the money it asked for” – and that the cash injection is “frontloaded”.

Asked on Sunday about the funding requested by NHS England for its five-year forward view, Home Secretary Amber Rudd replied: “We've delivered on that money”.

But Mr Stevens, giving evidence to the Commons Public Accounts Committee, said it was only in 2016-17 that the NHS was getting “broadly what we asked for”.

In years two, three and four of the plan – between 2017 and 2020 – the Government was providing less cash than requested.

Mr Stevens added: “In the years up until then, there’s a lot of work in hand – because we didn’t get what we originally asked for.”

Even the overall £10bn package was only at the “lower end of the range” of what had been requested over five years – which was up to £21bn.

And, over the over the decade as a whole, since the Coalition came to power in 2010, the NHS was suffering an “unprecedented” funding squeeze.

Mr Stevens agreed there had been a “raid on capital” spending to provide more day-to-day funds, which would create “very substantial problems” for hospital buildings if it continued.

He also vented his frustration over the recent £170m pledge to rescue community pharmacies – coming from his budget, for the overall plan.

Mr Stevens was read the head of the National Audit Office’s conclusion that, without proper funding and tough efficiencies “the result will be some combination of worse services, fewer staff, deficits, and restrictions on new treatments”.

He replied: “I agree with that entirely. I wasn’t quite sure if that was one of my quotes.”

Ministers will point out that, last autumn, Mr Stevens welcomed the £10bn pledge, saying: “This settlement is a clear and highly welcome acceptance of our argument for frontloaded NHS investment.”

At that time, then-Chancellor George Osborne claimed that, of the £10bn “almost £6 billion is frontloaded”.

But a report by the Commons Health Select Committee concluded cuts to public health and training budgets, and the use of capital funding to plug deficits, meant the real figure was much smaller.