Parties put forward NHS options

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Labour have warned the NHS in England would return to "the bad old days" under a Tory government as the parties argue over the health service's future.

Health Secretary Andy Burnham told the Daily Politics that, if re-elected, Labour would "protect" standards even though funding would be much tighter.

Tory counterpart Andrew Lansley said the NHS was their top priority but change was needed to make it better.

Lib Dem spokesman Norman Lamb said he would oppose any "slash and burn" cuts.

The three men set out their vision for the future of the NHS in England after the election, and how it will cope in an era when public spending is likely to be squeezed.

Labour have pledged to protect "frontline services" from future spending cuts while the Conservatives have said they would increase the NHS budget in real terms every year.

'Good service'

The Lib Dems have not ruled out cutting some NHS budgets, saying "significant" savings can be made in administration costs, but that funds will be re-invested in improved patient care.

Mr Burnham said the NHS faced perhaps its toughest challenge over the next few years but insisted the budgets of England's primary care trusts would rise 5% this year and be maintained in real terms in the two years after that.

"This locks in all of the funding increase Labour has put into the NHS over the past decade," he said.

Labour had transformed the NHS over the past year 13 years, he said, "making a poor service a good service for the vast majority today".

We can't make the sick in this country pay for Labour's debt crisis Andrew Lansley

If the Conservatives won the election, he said the gains of recent years could be lost and a return to "chaos in A&E departments", an increase in waiting lists and "postcode prescribing".

Mr Lansley said the Tories were the only party committed to real terms funding increases across the NHS but changes were needed to give patients more control over their care and reducing its "vast" bureaucracy.

"We can't make the sick in this country pay for Labour's debt crisis," he said.

Both opposition parties attacked what they said had been the growth in NHS administrators in recent years, claiming the NHS had taken on an extra 5,000 managers alone in the last year.

Mr Burnham said many of these were clinical staff and the number of nurses had increased by 90,000 since Labour first came to power.

Row over guarantees

The spokesmen also clashed over the future of Labour's two-week cancer guarantee, with Mr Burnham pressing his counterpart over whether people would still be able to see a specialist within two weeks of GP referral.

"It is absolutely legitimate for me to say that if these standards are taken away from the NHS people will wait longer for getting crucial cancer care," he said.

Mr Lansley said he would scrap "politically motivated" NHS targets but keep those that were "clinically justified".

Asked whether this meant the cancer guarantee would remain in place, he said "yes", adding that people in that situation "should see see a specialist rapidly".

We all know the next few years a going to be really tough for the NHS Norman Lamb

But he said these commitments must run alongside more focus on improving cancer survival rates by investment in technology and drugs.

Mr Lamb said local communities must have more say over the future of hospital services and threatened closures.

"We all know the next few years a going to be really tough for the NHS," he said.

"We can either go for slash and burn of services or we can re-design the way the NHS works to make the money go further and protect patient services."

Both Mr Lansley and Mr Lamb called for a review of the licensing laws to address concerns about binge drinking.

Asked about care for the elderly, Mr Burnham said he would work to build a consensus over the issue but said Tory plans for a voluntary levy would not end the fear of people having to sell their homes to fund care.

Mr Lansley said Labour had no idea about how it would pay for its own plans for a national care service.

Mr Lamb said reform was "long over-due" and an agreement was possible within a year "if we have the will".