Senior MPs, including a former Tory Health Secretary, today cast doubt on the Government's ability to save £20bn across the NHS without rationing important services.

In a highly critical report, the Commons Health Select Committee says hospitals are resorting to short-term "salami slicing" cutbacks rather than making difficult decisions about how the NHS of the future should look. It says the Government's controversial NHS shake-up is exacerbating problems in the service, and calls for much greater integration between social care, provided by councils, and healthcare provided by the NHS.

The attack is especially damaging because the committee is chaired by one of Andrew Lansley's Tory predecessors, Stephen Dorrell, and is dominated by Tory and Liberal Democrat MPs. The report notes there is a "marked disconnect between concerns expressed by those responsible for delivering services and the relative optimism of the Government" over achieving cuts.

It says the committee has found "disturbing" evidence that the cost-cutting measures being implemented could be described as "short-term expedients" and that NHS bodies are "making do and squeezing existing services" simply to get through the first year of the cuts than looking for long-term reforms to practices.

In a stark warning, the MPs conclude that it is "far from certain whether the targets ... will be met, even with trusts stretching themselves".

The tough task is made harder by the fact that the Government is pushing through its shake-up of the entire health service structure at the same time.

Last night, Mr Lansley insisted the Government's plans for modernisation were essential if it was to put the NHS on a sustainable footing. "Only when we give nurses and doctors more power will we see local NHS services reshaped to suit patients so they can see who they want where they want," he said.