Frontline job cuts in the NHS will have "catastrophic consequences" for patient safety and care, with nurses accounting for almost half of all positions to be axed, a nursing union warned on Monday.
Nurses and healthcare assistants represent 46 percent -- 4,429 -- of planned staff cuts, which the union says will lead to "fewer services, fewer nurses and a worse NHS".
The union has identified a total of almost 40,000 posts across 130 NHS organisations in England facing the axe over the next three years -- a rise from 27,000 at the end of last year. Most of the job losses are expected to happen through natural turnover, from people retiring or leaving.
The latest attack on health cuts comes after Prime Minister David Cameron last week launched a "listening exercise" amid anger from unions and patient groups over the coalition's radical reform plans. He said he was willing to make changes to the plans but stressed that "the status quo is not an option".
The NHS is attempting to make efficiency savings of £20billion by 2014-15, but the government has pledged a real-terms increase in health spending and repeatedly said frontline services should not be affected.
However, Dr Peter Carter, RCN chief executive and general secretary, said the latest figures bely Cameron's assertions that frontline staff and services will be protected.
"Many trusts are not being transparent by admitting to the proportion of clinical jobs being lost," Carter said.
"From our research we now know the truth -- the majority of job losses are frontline clinical jobs, the jobs that matter to patients.
"Cutting thousands of frontline doctors and nurses could have a catastrophic impact on patient safety and care. Our figures expose the myth that frontline staff and services are protected."
Carter said patients were not getting access to the same care they did only a year ago, with key community services such as family nurse partnerships and "talking therapies" for depression being closed.
"We know that savings need to be made but cutting frontline staff and services is not the way to do it," he added.
Health Minister Simon Burns stressed on Monday that the number of nurses in the NHS was actually 2,600 more today than in 2009.
He said the government had also pledged a real-terms increase of £11.5 billion in spending over the next four years in the NHS.
"What is important and what the government and the Department of Health have made quite plain to the NHS is that priority has got to be given to protecting and supporting frontline services," Burns told BBC Breakfast.
"We are honouring our pledge for real-terms increases in funding, there is this £20 billion efficiency saving where every single penny has got to be reinvested in frontline services so that patients are at the heart of care."
A spokesman for the Department of Health added: "The government is getting rid of bureaucracy and clinically unjustified targets so that nurses are freed up to do what they do best -- taking care of patients.
"We are also protecting the NHS, ploughing in an extra £11.5 billion of funding. Any efficiency savings must not impact adversely on patient care."
The attack puts further pressure on the Conservative-Liberal Democrat coalition over its health reform bill, which came under fire on Sunday from the Lib Dems' senior parliamentary adviser. Norman Lamb, a government whip, threatened to resign unless certain demands were met, warning that pushing the changes through too quickly would pose a "financial risk" to the NHS.
The reforms as they stand would abolish primary care trusts and hand 60 percent of the NHS budget to GP-led consortia by 2013.
Source: AFP European Edition