Patient groups and unions have welcomed the report by former NatWest chief executive Derek Wanless calling for a substantial rise in health spending over the next 20 years.

However, they have expressed fears that even increasing funding to �184bn by 2022 will fail to ensure improvements are achieved on the ground.

Mike Stone, chief executive of The Patients Association, said: "We welcome expenditure on the NHS but we would need to ask whether it will bring about true improvement for patients."

Mr Stone highlighted the government's attempts to boost the use of information technology in the health service saying it had failed to improve despite a major injection of funds.

This report marks a watershed for the medical profession Dr Ian Bogle, British Medical Association

"One of the key recommendations in the report is that the IT system in the NHS needs to be sorted out, and we totally agree.

"But there has already been huge expenditure on IT and the whole system seems to be in total disarray.

"So how exactly it can be sorted out is unclear, because the system is so far behind the times."

Long-term strategy

Dave Prentis, general secretary of health union Unison, warned that it would take years of extra funding to improve the NHS.

"There is no doubt that the problems confronting the NHS are a legacy of years of under-investment and neglect.

Our health service needs a massive injection of funds and we believe the majority of people in this country understand and support that Dave Prentis, Unison

"It will take years to recover the situation but we believe it can be done.

"We need to get spending up to the European average on health if we are to achieve the goal of a world class health service.

"Not only do we have to get spending up, we need to get the money spent. Far too much cash is being under-spent or tied up in unwieldy long-term PFI (private finance initiative) contracts.

"We in Unison understand that raising taxes is a very difficult decision for the government. But you can't achieve world-class public services on the cheap.

"Our health service needs a massive injection of funds and we believe the majority of people in this country understand and support that."

Dr Ian Bogle, chairman of the British Medical Association, said: "This report marks a watershed for the medical profession.

"The need for thousands more doctors has been recognised at the heart of government."

He added that planning 20 years in advance was "a hugely important step forward" because past failures to plan far enough ahead had led to problems delivering improvements in patient care due to a critical shortage of doctors and nurses.

Dr Bogle added: "But it is tremendously good news to see that the expansion we all know is needed, can be afforded."

Dr Beverly Malone, general secretary of the Royal College of Nursing, said: "The report highlights the need for increased numbers of health care workers in the future to deliver a better service to patients - an issue with which the RCN is greatly concerned.

'Major step forward

Independent health charity the King's Fund said money should help to fight the causes of poor health.

A spokesman said: "The report rightly argues that more money is needed to tackle health inequalities as this will reduce costs in the long run.

"As we know poverty remains the biggest single cause of ill health in the UK."

We have already seen a massive cash injection into the NHS in recent years but patients are still waiting longer to see their GP and their consultants Dr Liam Fox, Shadow Health Secretary

Mike Hall, chief executive of Standard Life Healthcare, said the report was "a major step forward in revitalising the NHS"

Private health insurer BUPA warned that any extra money must be linked with reform.

In a statement, it said: "More money alone, whether from taxes or other means, will not solve the problem. More fundamental reform of national healthcare is required.

"Productivity, innovation and organisational efficiency all need to improve. Without these changes, people will not get the healthcare they need and want."

Political criticism

Politicians used the report to launch an attack on Labour's record in government since it was elected in 1997.

Shadow health secretary Dr Liam Fox questioned whether the extra money would make a difference.

"We have already seen a massive cash injection into the NHS in recent years but patients are still waiting longer to see their GP and their consultants.

"Before the government taxes more they ought to make sure they are using the money wisely. Without substantial reform which makes that money available to patients care they will be wasting that money.

"What we are getting from the government today is more talk and more tax."

Liberal Democrats health spokesman Dr Evan Harris said: "This report is a thinly veiled attack on Labour's first term. It clearly demonstrates the disastrous failure of Labour to put in the necessary funding, particularly for NHS capital projects.

"The implicit criticism reflects persistent Liberal Democrat attacks on the government for failing to spend NHS capital, partly due to the time and effort taken to negotiate PFI schemes."