INCREASES in NHS spending in Wales are likely to be much smaller in the foreseeable future, a Gwent health boss is warning.

Martin Turner, chief executive of Gwent Healthcare Trust, said the indications were that by the time budget increases during the next couple of years were offset by inflation and other cost increases, health bodies might be faced with shortfalls of 3 or 4 per cent.

In Gwent that would be £13 million to £17 million to be found by efficiency savings.

"As a health community (the trust and Gwent's five Local Health Boards), we should assume such shortfalls in the next couple of years," Mr Turner told the trust board.

Already faced with a budget deficit of almost £43m this year, caused by a series of issues including a deficit in funding for the nationwide Agenda For Change pay modernisation programme, trust and LHB bosses are trying to plan more savings into a three-year financial recovery plan to meet what could be a £50m shortfall in total.

Elements of this have included a recruitment freeze in all but exceptional circumstances, bed closures, ward reorganisation and other measures that could, if successful, save £12m this year and more than £20m in each of the next two years.

But the proposals have worried health unions, with Unison in particular concerned about the consequences for staff of changes in work patterns and staff redeployment.

Mr Turner said staff would be consulted about proposed changes and vowed not to compromise patient safety, but he has warned that in financial terms the next few years will be extremely challenging.