Nurses, doctors and opposition parties have reacted with anger and incredulity to a claim by the Health Secretary, Patricia Hewitt, that the NHS has had "its best year ever".
As the Royal College of Nursing warned that more than 13,000 NHS jobs were set to be lost because of the £600m deficit and it was reported that 11 out of 26 health targets are not on track to be hit, Ms Hewitt insisted that health care was improving.
She said that job cuts mainly affected agency or temporary staff and that the mounting financial problems facing the NHS were down to a "minority" of poorly performing Primary Care Trusts (PCTs).
In an interview with The Independent, Ms Hewitt said: "We are seeing already the transformation of the health service and - although you would never think it to read the headlines - the NHS has just had its best year ever with more people being treated faster and better than ever before, in the coldest winter for decades, not only with no winter bed crisis, but with waiting lists reduced to their lowest level ever." She said that patient care would not be affected by the job losses or deficits facing PCTs.
Ms Hewitt admitted that well-performing PCTs who ended up with an end-of-year surplus would not now be allowed to keep the money but would have to hand it over to be ploughed back into trusts with deficits.
The Royal College of Nursing (RCN) said at the start of its annual conference in Bournemouth that more than 13,000 NHS posts had been lost in the past year - one third of them nursing jobs.
Almost two thirds of ward sisters surveyed by the RCN said that they did not have enough staff to give patients the care they felt they deserved.
Dr Beverly Malone, general secretary of the Royal College of Nursing, said: "If this is the best year ever I would hate to see the worst. What the Secretary of State is saying just doesn't match with the reality of what nurses know. We know that nursing jobs are being lost, and when there are not enough nurses, care is not delivered as efficiently as it should be." Dr Malone said central funds needed to be allocated to the crisis.
The RCN is concerned that plans to move many aspects of care from hospitals to the community are being rushed through without the infrastructure or staff in place.
It emerged yesterday that a cabinet committee on NHS reform, chaired by Tony Blair, had been told last week that trusts were not on track to meet 11 health targets, including reducing cancer waiting times and cutting rates of hospital infections such as MRSA. Almost one in five trusts are missing the target of a maximum two-month wait for cancer patients to receive treatment from the time they are referred to a GP, while MRSA deaths rose by 22 per cent between 2003 and 2004.
The Conservative leader, David Cameron, said the Government had "mismanaged" the health service. "It's a crisis that was pretty much manufactured in Downing Street," he said.
James Johnson, chairman of the British Medical Association said: "This certainly isn't the best year ever for the thousands of NHS staff who could lose their jobs or for the patients whose operations have been delayed so trusts can save money. It is true that waiting times are down but the NHS is now facing a whole new set of problems."
'It is very stressful being a student nurse'
By Kim Sengupta
Charlene Baldwin recently completed a three-year diploma course in health care and education in nursing at the University of Central England, in Birmingham. She had wanted to work at Birmingham Children's Hospital but there were no vacancies.
Ms Baldwin, 22, has been forced to move back to her parents' home in Northampton and is due to take up a post at Milton Keynes General Hospital.
She said: "A lot of friends on my course haven't got jobs either and are also being forced to move out of the West Midlands.
"It is stressful being a student nurse at the moment. We used to have a job lined up before we qualified. But now you see 60 people going for the same post."
Ann Leedham Smith, West Midlands director of the Royal College of Nursing, said: "We have already seen 700 nursing redundancies in the region. The Government spent millions training them and they are now being let down badly.
"We are also concerned that patient care is being put in danger as so many nursing jobs are being axed. There has been too much reforming too quickly."