Critics say people could die because of the cuts

Government spending cuts may become a matter of life and death, it was claimed last night, as it emerged that almost two million people could wait longer for cancer tests and up to 10,000 firefighters face the axe.

The highly charged claims appear to contradict pre-election promises made by David Cameron to protect frontline services. However, the Prime Minister last night made an upbeat plea to the nation to support the plan to cut £81bn over the parliamentary term, insisting the decisions made in last week's Comprehensive Spending Review were tough but fair, and gave businesses confidence to invest in Britain.

"I know the road ahead will be hard," Mr Cameron said in a podcast on the Downing Street website. "Believe me, the destination will be worth it – a Britain with a strong, positive and confident future."

His message was echoed by Danny Alexander, the Lib Dem Chief Secretary to the Treasury, who reveals in an interview with the IoS that ministers will stagger the timing of public sector redundancies in the regions to prevent "really localised hotspots of joblessness". Both men insisted that the Government had protected the services that families rely on, such as the NHS, schools and social care.

But the Opposition condemned the coalition for dropping Labour's pledge for all cancer patients to undergo diagnostic testing within a week of being seen by their GP – this, it claimed, will leave 1.8 million people with suspected cancer facing a longer wait for tests over the next five years. During the election campaign the Tories accused Labour of "scaremongering" when they said cancer care would be threatened by a Conservative government.

John Healey, the Shadow Health Secretary, said: "Ministers have ignored official warnings and axed planned improvements in cancer care. Waiting times will rise for people desperate to find out if they've got cancer and get the treatment they need."

But Andrew Lansley, the Health Secretary, insisted the coalition had never committed itself to a one-week target because "there is not enough clinical evidence to support it" and claimed Labour had never said how the target would be paid for.

"We are fully committed to improving early diagnosis for people with cancer. Up to 10,000 lives a year could be saved if England's survival rates were brought up to the best levels in Europe," Mr Lansley said. Coalition policy would "put clinical judgement first – not process-based targets", he added. Health spending was protected in George Osborne's statement last week.

The dispute follows a stark warning from Nigel Edwards, head of the NHS Confederation, that hospital beds will be blocked "for those who badly need care because the support services the elderly require after discharge will not be available". The Department of Health insisted an additional £2bn had been allocated to social care by 2014-15.

Meanwhile, firefighters warned that public safety would be threatened by plans to cut 25 per cent from their budget over four years. Matt Wrack, general secretary of the Fire Brigades Union, said the "pernicious cuts must be fought to defend public safety". Mr Cameron, during his round-the-clock pre-election blitz, promised: "We want to get money to the front line. We want a really good fire service, but where we can get savings in back-office costs we should."

Mr Wrack told the IoS: "The figures announced last week show the hollow cynicism of that empty pledge." John Drake, regional secretary of the south-west FBU, said: "It is inevitable that strikes will follow."

Thousands of firefighters in London yesterday walked out on strike in a bitter row over new contracts. There were also angry scenes in Glasgow and Belfast during protests against cuts. The TUC announced that a national rally will be held in London's Hyde Park in March next year. An ICM poll for the News of the World found that 77 per cent of people believed their family's income would fall as a result of the cuts.

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