One in 10 people in England will be on the NHS waiting list unless the health service is given more money, the head of NHS England has said.
The waiting list will expand to five million by 2021 without more money for the NHS, he said.
Simon Stevens said that he was bound by the health service’s duty of candour to set out the consequences of what would happen without more funds.
On current levels of funding, the NHS will not be able to make improvements in cancer care or mental health, he added.
Speaking at the NHS Providers conference in Birmingham, Mr Stevens said: “We have a care fragmentation problem and a funding problem.
“Some may say ‘aren’t we spending at the European average?’ Well only if you think that bundling austerity-shrunken Greek and Portuguese health spending should help shape the benchmark for Britain.
“If instead you think that modern Britain should look more like Germany or France or Sweden then we are underfunding our health services by £20 to £30 billion a year.”
He added: “The Government has rightly supported the NHS through difficult times, it protected the NHS budget immediately after the financial crash, and funded modest growth ever since. But that growth rate is set to nosedive next year and the year after.
Simon Stevens spoke at the NHS Providers conference in Birmingham (Stefan Rousseau/PA)
“As I have told parliament on many occasions – ‘for the next three years we did not get the funding the NHS had requested. So 2018, which happens to be the 70th anniversary of the NHS, is poised to be the toughest financial year’.
He told delegates at the conference: “In our publicly funded health service, it’s the Chancellor of the Exchequer who rightly decides the NHS budget. But in a democratically accountable NHS, the public have a right to know what those choices would mean.
“Today I set out NHS England’s independent assessment. It is that the budget for the NHS next year is well short of what is currently needed to properly look after our patients and their families in their time of greatest need.
“After seven years of understandable but unprecedented constraint, on the current budget outlook, the NHS can no longer do everything that is being asked of it.”
He added: “That assessment is confirmed today by the King’s Fund, Nuffield Trust and Health Foundation, they independently size next year’s funding gap at £4 billion.
“They show there’s nothing out of the ordinary about needing such a sum. In their words, it’d just be a return to the average increases of the first 63 years of the NHS’s history, as against the exceptional choking back of funding growth of the past seven years.
“Our duty of candour requires us to explain the consequences of these decisions to help inform the difficult choices that will be made in the years ahead.
“It boils down to this, on the current budget, far from growing the number of nurses and other frontline staff, in many parts of the country next year, hospitals, community health services and GPs are more likely to be retrenching and retreating.
“On the current funding outlook, it is going to be increasingly hard to expand mental health services or improve cancer care – services the public need and rightly want.
“And crucially, on the current funding outlook, the NHS waiting list will grow to five million people by 2021. That’s an extra million people on the waiting list. One in 10 of us waiting for an operation – the highest number ever.”