Health service managers issued a last minute pre-Budget plea to a government 'hooked on targets' to inject the NHS with 'cash without strings'.

Barry Elliott, chair of the Healthcare Financial Management Association, said: 'The service is under enormous pressure operationally and financially.

What our members want is a general increase in funding which is not targeted. But that is more of a hope than an expectation - this government is hooked on targets and additional resources have to be justified. '

Ken Jarrold, chief executive of County Durham health authority, said it was 'absolutely vital that a substantial proportion of new money is not badged', a view shared by Chris Heginbotham, chief executive of East and North Hertfordshire HA.

He called for a 'fairly substantial recurrent addition to NHS spend. . .

perhaps another£1bn', because 'the policy initiatives are already in the pipeline - now we need the money to fund them'.

Roger Sirman, finance director at the Homer ton Hospital trust, east London, said extra resources for new initiatives in the last two or three years had put 'undue pressure on the underlying cost base'.

And Alan Randall, chief executive of Eastbourne Hospitals trust, was among many urging the government to 'stop turning the screws on cost improvement programmes which are more and more difficult to achieve'.

Despite widespread agreement on the need to invest in critical care, senior managers were cynical that any such move could reflect a 'political desire' to avoid last winter's crises headlines.

At Avon HA, currently hitting newspaper headlines for its failure to fund Ribavirin for a patient infected with hepatitis C through a blood transfusion, chief executive Pamela Charlwood called for 'a pot of money created specifically to meeting recommendations' from the National Institute for Clinical Excellence.