Lack of clarity over where NHS savings go, say MPs
There is a lack of clarity over what the money saved in the NHS in England has been spent on, say MPs.
The NHS is in the middle of an efficiency drive with savings expected to be reinvested in front-line care and making services more productive.
More than £10bn has been saved in the first two years with another £4bn forecast in 2013-14.
But the Health Select Committee said there was little evidence it had been used wisely.
The cross-party group of MPs said the plan had been to transform the way services were delivered to make the NHS sustainable in the long-term.
But it said, to date, much of the savings had come from "straightforward" measures such as pay freezes and cutting funding to hospitals.
It said as a result, the pressures on the NHS and social care system were now greater than they were a few years ago.
Committee chairman Stephen Dorrell said: "We have not seen the transformation of care on the scale which is needed to meet demand and improve care quality.
"The NHS budget is static and the social care budget is falling. In these circumstances, the successful integration of high-quality health and care services represents a substantial and growing challenge."
He said it was now important to ring-fence the social care budget and he also wanted to see councils getting more involved in planning care through their health and well-being boards as that would make joined-up care more likely.
The government has already acknowledged that more sustainable savings need to be made as the use of pay-freezes cannot be used for the long-term.
And writing in the Daily Telegraph, NHS England chief executive Sir David Nicholson, who is retiring in April, said he wanted to see a "radical" transformation with care being centralised in major hospitals and more integrated services provided in the community between GPs, nurses and social care.
"Our NHS does a superb job for millions of people, day in day out, but it cannot stand still - it needs to adapt to survive," he added.
But Prof John Appleby, of the King's Fund think tank, said: "In the short-term, finances are tightening significantly with a growing number of hospitals now in deficit.
"This raises real questions about whether the NHS will be able to maintain its recent record of balancing its books at the end of the financial year.
"Beyond 2015, the prospects look even more challenging, with further cuts in public spending likely whoever wins the general election.
"It is now almost inevitable that the next government will have to find more resources for health and social care if services are to be maintained."