Short-term policy making and a decade of underinvestment has left the NHS in a “critical condition” as it turns 75, health experts have warned.

Three leading thinktanks said the service may not reach its 100th birthday without more resources being pumped into it and fundamental reforms.

Separately, NHS Providers – which represents hospital trusts – warned of “enormous pressures” amid a record rise in demand for care and “the biggest financial squeeze in its history”.

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In an interview with Sky News, Health Secretary Steve Barclay refused to accept Conservative spending cuts have played a role in problems faced by the health service – blaming an ageing population, rising costs and the pandemic instead.

But Sir Julian Hartley, chief executive of NHS providers, told Sky News: “It is important to remember that it wasn’t just the pandemic.

“From 2010 to 2019, the NHS spent 18% less than 14 other European countries, so in terms of investment in the NHS, and indeed social care – those are critical issues to resolve.”

He said the NHS is the “most pressurised” it has been in his 30-year career, with its challenges including a rise in demand for emergency care, a lack of reform in social care and a staffing crisis.

The size of the waiting list – currently a record 7.4 million people in England – is also a “major issue”, he said.

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While measures have been announced to address some of the problems, such as the recently unveiled long-term workforce plan, Sir Julian said “that is against the backdrop of enormous pressures of industrial action, of the biggest financial squeeze the NHS has seen for some time”.

The warning came after health minister Maria Caulfield told Sky News that the record-high waiting list “will go up before it comes down”, because the NHS is “offering more procedures”.

She could not detail how much she expects the list to rise by, but insisted that the time between referral and treatment is falling.

‘Decisive break-point’

Ms Caulfield said that the NHS will be “thriving” in 25 years’ time, despite assessments from thinktanks that its future hangs in the balance.

The King’s Fund, the Health Foundation and the Nuffield Trust said that public support for the NHS is “rock solid”, but the service will not be around to celebrate its 100th anniversary without more investment.

They said the service has “endured a decade of underinvestment”, as they attacked an “addiction to short-termism and eye-catching initiatives” which will not help it survive in the long-run.

In a letter to Prime Minister Rishi Sunak and the leaders of the Labour and Liberal Democrat parties – Sir Keir Starmer and Sir Ed Davey – they said the next election should be “a decisive break point” by ending years of short-term policy making when it comes to the NHS.

The organisations said “unachievable and unrealistic” fast improvements without long-term planning will “doom the service to failure”.

The letter said: “Seventy-five years after its creation, the National Health Service is in critical condition.

“The next government will face a choice between providing the investment and reform needed to preserve the NHS for future generations or continuing with short-termism and managed decline.”