24/11/2015 14:48 GMT | Updated 24/11/2016 05:12 GMT

Whatever the Chancellor Says on Wednesday, the Prognosis for the NHS Is Still Not Looking Good

When George Osborne took to the TV studios today to sell his latest "promise" on the NHS, many people will have felt a touch of scepticism about whether it really does what it says on the tin.

And they would have been right to feel that way.

We won't know the full nature of the Government's funding plans until the Chancellor stands up in the House of Commons at lunchtime tomorrow, but one thing is for sure - the devil will be in the detail.

Any additional investment in the NHS is welcome, particularly at a time when hospitals are forecasting an eye-watering deficit of £2.2billion this year - and when demand for care is going up.

But if new money is simply used to plug a growing black hole in NHS finances and if it's funded by raiding budgets for nurse training, public health and older people's care, then it won't feel like new money at all.

Indeed, the lesson from the last parliament is that cutting preventative services, like social care, only piles the pressure on hospitals and adds to the growing demand on health services.

The cuts to nurse training places we saw in the early years of the last parliament - which led to 10,000 fewer nurses being trained - created a shortage of qualified staff. This is the key reason why agency spend within hospitals last year stood at £3.3billion. And it's why personnel departments are having to travel to countries as diverse as Spain and the Philippines to recruit from overseas.

It's also no coincidence that delayed discharges from hospital - where patients cannot be discharged because there isn't support available for them outside of hospital - have reached a record high in recent months. Social care budgets have been repeatedly cut, and when older people don't have the support they need to remain independent in their own home, they all too often end up in hospital.

Unfortunately, it looks like the Government is about to make the same mistakes all over again.

And they can't say they haven't been warned.

Simon Stevens, the chief executive of NHS England, recently set out a number of 'tests' for the Government ahead of the Spending Review. It looks like at least two of those tests - investing in social care and 'making good' on public health - won't be met.

The other issue Ministers will soon have to confront is that their funding plans are predicated on making £22billion worth of efficiency savings in the NHS by 2020. No-one in the NHS seriously believes that efficiencies on this scale can be delivered without harming patient care.

And if £22billion cannot be delivered, the NHS is going to need a lot more money than this Government seems prepared to spend. Whichever way you cut it, the decade between 2010 and 2020 is likely to be marked by the longest and deepest squeeze on NHS finances in a generation.

The truth is that whatever George Osborne says tomorrow, no amount of spin will disguise the fact that the prognosis for the NHS is still not looking good.

Heidi Alexander is the shadow health secretary and Labour MP for Lewisham East