The amount of care received by NHS patients is failing to keep up with an increase in funding, official figures reveal.
Data from from the Office for National Statistics (ONS) found productivity in healthcare fell by 3.3% between 1995 and 2008, corresponding to an annual average drop of 0.3%.
Health minister, Mike O'Brien, said the fall in productivity was a result of a programme to recruit much-needed extra staff for the NHS.
He said: "In 1997, the NHS was severely under-staffed and under-funded. We have had to address this under-staffing and that has affected productivity."
However, the mismatch between inputs and outputs shows that while funding and staff levels may have increased, the amount of work achieved has not risen by the same amount.
This means there was a drop in the amount of NHS activity for every pound spent on publicly funded healthcare.
Inputs refer to the volume of goods and services, including clinical supplies, and spend on staff including nurses, doctors and support workers. Healthcare inputs grew by 75%, averaging 4.4% growth a year, the ONS data showed.
But healthcare output grew by just 69% overall, averaging 4.1% growth a year.
From 1995 to 2001, productivity was broadly stable as output and inputs grew at a similar pace, the ONS said.
But from 2001 to 2008 productivity declined as inputs grew more quickly than outputs every year except 2005 and 2006.
Productivity in 2008 is estimated to have fallen by 0.7%, compared with a fall of 0.3% in 2007.
"Many community staff claiming less than 2500 miles yearly have had their car allowance taken away, those claiming more are to be paid less per mile, how is that for effiency saving!" - Name and address supplied
"We still have far too many managers that are overpaid and not doing a good job. Nurses are not managers!" - Jacqueline Habgood-Painter, Dorset
"I think the 'input' went on management not front line therefore productivity will suffer as they justify their existence by making cuts and losing jobs by not replacing staff" - Lou