The NHS is facing a “make or break” moment in its history, NHS Confederation chief executive Steve Barnett told delegates at the conference today.

“This year’s conference sees us standing at the threshold of what’s clearly going to be a most challenging, even make or break period in the history of the NHS,” he said.

“A change of government will not change our predicament”

Steve Barnett

Speaking on the day that shadow health secretary Andrew Lansley had insisted “real terms growth” for the NHS would continue after 2011 under a Conservative government - at the expense of other government departments – Mr Barnett said the confederation had calculated that the health service could face real terms funding cuts of up to £20bn in the three years from 2011.

“A change of government will not change our predicament,” he stressed.

‘Two years for radical action’

“The cold hard fact is that today we have just under two years to take radical action if our NHS is to remain true to its founding principle of excellent care free at the point of need.”

He pledged to defend managers in the face of any claims that the NHS could be run by frontline staff alone.

“The notion that managers somehow get in the way of patient care is more than merely misguided. It is preposterous to imply that such an enormous and complex service can operate effectively without the crucial role played by managers and leaders.

In managers’ defence

“I intend to address that distortion head on and defend in a properly balanced way the real contribution that managers make – delivering care to patients – part of the broader team, not sitting on the bench.”

As finances tightened, local leadership was vital, he said. “Local leadership in good times and in bad times, that’s your calling and that will strengthen the reputation of NHS managers.”

He called for “disruptive and courageous innovation” and called on the Department of Health “to deliver on devolving to you”.

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