NHS 'is not fit for the future'
The health service is not fit for the future and must change, the medical director of NHS England has said, but he denied that it is in crisis.
Sir Bruce Keogh said the health service will struggle to cope if it continues to function as it does now, with questions likely to be raised over whether the idea of free healthcare is sustainable.
Earlier this month figures showed that w aiting times in accident and emergency departments in England had plummeted to their worst levels in more than a decade, with just 92.6% of patients being seen within four hours.
In an interview with the Guardian newspaper Sir Bruce said the NHS must undergo a "complete transformation" of how it works.
"If not, we will get to a place where the NHS becomes unaffordable and we will have to make some very difficult decisions which will get to the very heart of the principle of the NHS and its values," he said.
"This will open up a whole series of discussions about whether the NHS is fit for purpose, whether it's affordable, and whether the compact with the citizen of free healthcare for all is sustainable in the longer term."
Last week Sir Bruce told the Commons Health Committee hospital A&E departments were under "considerable pressure", with 20,000 more patients attending A&E during Christmas week than there were in 2013.
He said it would be "foolish" to claim there would be no repeat next winter of the problems which have seen hospitals fail to meet their target of seeing 95% of A&E admissions within four hours.
Professor Keith Willett, the director of acute care for NHS England, told the Committee the focus must shift to out-of-hospital services to help reduce demand on hospitals, adding that any transformation could take between three and five years.