British Medical Association chairman Dr Hamish Meldrum said the whole of the UK faced a struggle to cope with rising demand and limited resources. Speaking at the BMA's annual conference in Cardiff, he warned of tough times ahead and difficult decisions to be made.
Doctors from Scotland also voiced concerns about the potential of further cuts to patient care. In the past year, more than 3,500 posts have been cut from the NHS in Scotland. More are expected to go, with health boards in the process of submitting workforce plans to the Scottish Government.
Scotland's largest health board, NHS Greater Glasgow and Clyde, is also considering limiting access to so-called low gain procedures, such as varicose vein surgery and tonsil removal. Other boards may follow suit. While major cuts to the NHS in Scotland were put on hold ahead of the Holyrood elections, there are fears changes will start to be made over the coming year.
Dr Meldrum told the 500 delegates of the "challenge of ever-increasing demand, finite resources and the most difficult financial situation in the NHS - in all four nations - has ever faced in its 63 years.
He continued: "Yes, we can argue about the extent of the savings that need to be made, we can debate the timescale over which they have to happen and we can condemn the bankers who got us into this mess in the first place. But there remains an inescapable truth: the NHS - just like every other healthcare system in the world - has to adapt and change."
However, he warned: "There is a huge difference between adapt and change and slash and burn, between carefully planned reorganisations and knee-jerk closures and redundancies, between partnership working among health professionals, managers and patients and imposed, top-down, politically motivated diktat."
Dr John Garner, an Edinburgh GP and former chairman of BMA Scotland, said Scotland would be watching the situation in England to see where cuts were being made and decide what could be adopted here.
But he said further cuts in NHS staff were likely. "The big expense in the health service is staff. We have to realise there must be threats for non-essential staff," he said. "We would argue that all staff have a role to play, but they will make choice and ideally we would like to see it in non front-of-house staff."
He said patients may also have to accept longer waiting times if resources were reduced further, as well as services being located in fewer places.
Dr Brian Keighley, chairman of BMA Scotland, used his speech to point to difficult decisions facing the NHS."This government must admit that even with the protection of the health budget - promised during the recent election - the NHS faces tough times and that means tough choices. It is against this background that the SNP remains committed to its high-spend agenda: free personal care, free education and a range of other universal policies."Last night, a Scottish Government spokesperson said: "We have increased health spending from 10.2 billion in 2007 to 11.4bn today.
"The NHS in Scotland is being asked to make 3 per cent efficiencies for 2011-12 - this equates to 333m. All savings are retained locally by NHS boards to allow them to reinvest in services which directly benefit patients."