NHS spending growth under the Tories would be significantly less than that seen under Margaret Thatcher, Andrew Lansley has said.

The shadow health secretary repeated the Conservatives’ commitment to real terms increases in NHS funding in the next Parliament. But he said it would be “a tiny fraction” of that seen in the past, including what he said was an average 3.2 per cent annual real terms increase under the Thatcher governments.

He said: “Even that in my view is unsustainable and we will not approach anything like that in the next Parliament.”

Mr Lansley was addressing the Foundation Trust Network’s governance conference today.

Responding to concern that politicians’ promises of real terms growth meant staff would not accept the need for significant cost reduction, he said organisations should plan to improve productivity and efficiency to fund increased demand, developments in healthcare and provide better outcomes, but not for “cuts”.

Mr Lansley said: “There are primary care trusts that are sitting down and modelling a 20 per cent reduction in resources over five years. They are engaging in business planning that, in my view, is unrealistic.”

He said planning should be “so much more positive than simply a cuts debate”.

But he told the trust managers in Birmingham that funding for health would be “by no means a blank cheque” and that services would have to “tighten their belts”.

He said: “We’ve pledged real-terms increases in NHS expenditure … but they must go hand in hand with real savings, which can be ploughed back into front-line services to meet the needs of an ageing population and drag up our health care results.

“At a time when other parts of the public sector will be facing painful funding constraints, how will NHS staff look taxpayers in the eye and justify the priority they receive without real improvements in efficiency and results?”