The new health secretary has said the NHS might face greater efficiency savings than the 3 per cent planned for and that GPs would have a say on hospital reconfiguration.

In an interview on BBC Radio Four’s Today programme Andrew Lansley said although “the real value” of NHS spending would go up it “would not protect the NHS from the need to secure efficiency savings”.

Every penny that is saved by doing things better is a penny that can be re-invested

He said the rate of inflation in the NHS had sometimes run at three times that of the private sector and that this was “not sustainable”.

He told John Humphrys: “People across the NHS say ‘we cannot go on like that’.”

He mentioned programmes such as Agenda for Change as a necessary “one-off” that had had to be paid for, but added: “There is not now a basis on which people in the NHS can expect that it is exempted from the… broader pressures.

“It doesn’t mean people in the NHS should get pay rises that are not available to other people in the public service.

“People across the NHS know that after a decade in which there has been a decline in productivity and a rise in inflation in the NHS then the time has come for them to achieve efficiency savings

“I think they will understand that this is a remarkably positive thought, because every penny that is saved by doing things better is a penny that can be re-invested.”

He said over the recent past the NHS’s spending had gone up in real terms by 4.2 per cent a year, but he said: “We know we cannot possibly do that in the next few years.”

He said the planned efficiency savings of around 3 per cent a year needed to achieve £20bn of savings would still need to happen. He added: “We may need to do more, because of increases in demand.

 “If we are going to deal with the challenges of health and social care in the future it would be unsustainable if at the same time we were cutting the real value of the NHS budget.”

Challenged on the primacy of secondary care in the NHS and political opposition to reconfiguration he hinted GPs would have a much more important role in deciding on hospital closures.

He said: “I have campaigned against local hospital closures. We are going to stop the closure of hospital services where it has not been justified by the clinical evidence; where there has not been the public involvement and engagement that really is necessary and where GPs as local commissioners of services have not been engaged.”

“The point is not to treat what is happening in hospitals as immutable but for hospitals and community health care services and GPs to work together to deliver more integrated services, sometimes doing new things in hospitals, sometimes doing new things in the community.

He said the key question in a closure was: “Are the GPs locally and the public locally in favour or opposed?”