THE NHS faces “intense” pressure as it enters its 75th year amid a record rise in demand for care and “the biggest financial squeeze in its history,” health service leaders warned today.

NHS Providers chief executive Sir Julian Hartley warned that the threat of strikes, a lack of reform in social care and a rise in demand for emergency care are heaping pressure on the system.

But he said that the pressures cannot be solely blamed on the coronavirus pandemic.

It came amid admission from health minister Maria Caulfield that Prime Minister Rishi Sunak’s pledge to cut NHS waiting lists is going in the wrong direction.

The latest figures show a record 7.4 million people are waiting for treatment despite the PM’s promise to cut times in England as one of his key priorities in January — back when the list was at 7.2 million.

Leading think tanks the King’s Fund, the Health Foundation and the Nuffield Trust said the NHS has “endured a decade of underinvestment,” warning that the service will not be around to celebrate its 100th anniversary without more funding.

Sir Julian told Sky News: “The NHS is under intense pressure, that’s absolutely clear.

“I’ve worked in the NHS 30 years and I think this is perhaps the most pressurised I’ve seen it in terms of all of the challenges, in terms of recovering from Covid … urgent and emergency care demand is hugely significant, and then, of course, all the background issues around an ageing population and so on.

“But it is important to remember that it wasn’t just the pandemic — from 2010 to 2019 the NHS spent 18 per cent less than 14 other European countries — so in terms of investment in the NHS, and indeed social care.”

Celebrations to mark the anniversary took place across the health sector today, including with a special service in Westminster Abbey.

Health union Unison said that the best 75th birthday present Health Secretary Steve Barclay could give the NHS would be to agree to start workers’ pay negotiations in the autumn.

As part of the NHS pay deal agreed with unions in May, Mr Barclay promised to look again at the way health worker wages are set.

Unison said it would not be right for the minister to renew the NHS pay review body’s remit for the coming pay year while the process itself is being critiqued.

The government consultation reviewing the pay-setting process closed on Tuesday.

Unison head of health Sara Gorton said: “The pay review body process is long past its use-by date.

“Ministers initially refused to engage in pay negotiations with unions and employers last year, insisting the review body was the only way.

“That led to months of industrial unrest that benefited no-one.”

Ms Gorton said the pay review body process “takes too long, and isn’t nimble enough to keep up with rapidly changing economic circumstances.”

She said: “It leads to health workers in England missing out. And as pay is so key to solving the NHS staffing emergency, it means patients lose out too.

“The process may have worked for a while, but it doesn’t anymore.

“It’s time to call a halt to this costly, wasteful, and time-consuming exercise.”

Ms Gorton said ministers must be prepared to “get back round the table” to discuss how well the deal has held up against inflation.

“The review body was meant to take the politics out of pay and avoid strikes,” she added.

“It’s failed on both counts. Direct talks involving unions, ministers and employers are the only way forward.”  

Shadow health secretary Wes Streeting warned that the NHS will die without “the necessary investment and reform,” and hit back at the PM for seeking to blame striking NHS staff for his failure to cut waiting lists.

Downing Street said Mr Sunak was committed to bringing down overall waiting lists but the initial focus was on patients waiting the longest for treatment.