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  Courtesy Independent....
  
  Special report: 'This can't go on' - NHS chiefs urge new debate on health reforms
  
  An unprecedented crisis is approaching, say the health service's most senior figures
  
  Hospitals are "staring down the barrel" of having to cut the jobs of doctors and nurses -
  
  actions that could lead to another Mid-Staffordshire scandal - unless the NHS radically reforms,
  
  the organisation's head warns today.
  
  In a stark assessment of the perilous state of NHS finances, Sir David Nicholson said the health
  
  service faced a £30bn black hole in its finances by the end of the decade because of rising demand.
  
  And he predicted that unless politicians and the public accepted the need to shut and centralise
  
  services such as accident and emergency care, cardiac surgery and maternity units, the NHS
  
  would no longer be able to cope with demand. Sir David was backed in his remarks by the
  
  Medical Director of the NHS, Sir Bruce Keogh, and the Chief Nursing Officer, Jane Cummings.
  
  They called for a "national conversation" about how to reform the NHS and called for politicians
  
  to be honest with the public about what needed to be done.
  
  "What we're really worried about is an approach that would muddle through," Sir David said.
  
  "It won't. Seventy-five per cent of all the money spent by hospitals is on staff. [We're] looking
  
  down the barrel of reducing staffing on wards and that is just not acceptable."

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