The NHS works best when money is tight, the head of the health service has said.
Sir Jim Mackey, its chief executive, said the health service had a habit of wasting funds when they were too plentiful.
The NHS has had record spending increases in recent years, taking its budget to £242bn, with an approximate doubling in spending in the past 17 years.
But during the same period, NHS performance has deteriorated.
In the late 2000s, the NHS routinely achieved targets to see 98 per cent of A&E patients within four hours. In 2010 the target was relaxed, and the latest performance is at 77 per cent.
Much of the extra funding has been absorbed by pay rises, including a 29 per cent increase for junior doctors in the past three years.
Sir Jim told a conference of NHS leaders: “If I’m absolutely honest, in all the time I’ve been in the NHS, we’ve performed better, we’ve got better results when things are actually quite tight.
“Generally, when we’ve had flexibility, we tend to not spend it well.”
