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Spending Review: NHS facing squeeze despite budget rise Spending Review: NHS facing squeeze despite budget rise
(40 minutes later)
By Nick Triggle Health reporter, BBC NewsBy Nick Triggle Health reporter, BBC News
NHS staff are braced for job losses - despite the government's pledge to increase the £103bn budget for England. The NHS in England is to get above inflation rises in its budget so that it rises from £104bn this year to £114bn by the end of the parliament.
Historically, health spending has gone up by over 4% in real terms so unions say a small rise will feel like a cut. But the rise is still a fraction of what the NHS is used to.
This is because demands from factors such as the ageing population, obesity and the cost of new drugs mean about an extra 3% is needed just to stand still. Historically, health spending has gone up by over 4% in real terms, prompting unions to say ahead of the announcement that a small rise will feel like a cut.
In preparation, the NHS has been asked to find large efficiency savings over the coming years. This is because the ageing population, obesity and the cost of new drugs mean an extra 3% is needed to stand still.
In preparation, the NHS has already been asked to find efficiency savings.
The previous government set a target of between £15bn and £20bn by 2014 - which means finding nearly 5% of savings a year.The previous government set a target of between £15bn and £20bn by 2014 - which means finding nearly 5% of savings a year.
This target has been kept in place by the coalition despite its promise to increase the health budget in this parliament from April - the details of which will be given in the Spending Review. This target has been kept in place by the coalition despite its promise to increase the health budget in this parliament from April - the details of which have now been given in the Spending Review.
Announcing the increase, Chancellor George Osborne said: "The NHS is an intrinsic part of the fabric of our country. It is the embodiment of a fair society.
"To govern is to choose. And we have chosen the NHS. That does not mean we are letting the Health department off the need to drive forward real reform and savings from waste and inefficiency."
He also said the cancer drug fund, promised before the election, would be created, while spending on health research would be protected along with a host of new hospital projects.
He also said social care would get an extra £2bn over the next four years.
'Financial pressures''Financial pressures'
While ministers say all savings from the efficiency drive will be reinvested into the NHS, unions have claimed "slash and burn" approaches are being taken. While ministers say all savings from the efficiency drive will be reinvested into the NHS, unions are concerned about job losses.
The Royal College of Nursing estimates more than 10,000 posts have closed in recent months and said if this trend continues patient care will be hit.The Royal College of Nursing estimates more than 10,000 posts have closed in recent months and said if this trend continues patient care will be hit.
There have already been reports of hospitals closing wards and restricting access to minor operations, while fears have been voiced that waiting lists could rise in the future.There have already been reports of hospitals closing wards and restricting access to minor operations, while fears have been voiced that waiting lists could rise in the future.
Nigel Edwards, of the NHS Confederation, which represents managers, said: "The public need to go into this with their eyes wide open.
"The NHS may have some limited protection to its budget but it still faces a potent cocktail of financial pressures."
Other parts of the UK will have to wait longer to find out about health spending with final decisions not expected until later this year.
Ministers in Scotland, Wales and Northern Ireland have talked about protecting parts of the NHS budget, although they have not been as categorical as their counterparts in England.