A "complacent" Department of Health will face an annual £10bn shortfall unless it speeds up efficiency savings across the NHS and considers cuts to social care and cancer research charities, according to a secret Whitehall report leaked to the Guardian.
The damning report warns that ministers will face an "unpalatable trade-off" between longer waiting times or a massive increase in the NHS budget unless dramatic savings are found.
It also warns that the central reform proposed by health secretary Andrew Lansley – to devolve 80% of the NHS budget to GPs – could have "patchy" results.
The findings are outlined in a blunt letter to Danny Alexander, the Treasury chief secretary, from the Independent Challenge Group, which was set up at the time of the budget in June to question Whitehall thinking.
