The NHS is under "severe pressure" because of staff shortages, recruitment freezes and redundancies, the largest public sector union warned today.
Unison said the government's squeeze on public spending was "dragging" the health service back to the 1980s and 1990s when the NHS was "starved" of funds.
A survey of more than 8,000 staff showed that hospitals were freezing recruitment, cutting posts and outsourcing or cutting services.
Unison said its study revealed a frontline under pressure, with more patients treated by fewer staff.
Karen Jennings, Unison's head of health, said: "What is truly distressing is that that the survey clearly shows how spending cuts are already threatening to damage the quality of patient care.
"The government is turning back the clock and dragging the country back to the dark days of the 80s and early 90s when the NHS was starved of money.
"Back then, patients who could afford it, paid up to avoid being at the end of a very long waiting list or being treated in poorly maintained hospitals.
"Government cuts threaten to undo and reverse the benefits of all the investment and hard work that has gone into turning the NHS around over the past 13 years. We have been able to train our own nurses instead of scouring third world countries to fill shortages.
"In a worrying reversal, half the people we surveyed are affected by staff shortages. This is particularly dangerous because the lack of staff was a key factor in the appalling problems with patient care at Mid Staffs Hospital."
"What beloved NHS? It's on its knees and has been long before the Lib/Con government came into power. Yes million of pounds have been 'invested' but there is very little evidence that any of it has made a real difference. Yes we have got new hospitals and health centres but we will have paid enormous amounts of money of money for the privilege via PFI. and yes the wards are still staffed with nurses from abroad whilst many home trained cannot get work. Don't kid yourself, no one else is" - Nurse, Lancs
"This coalition government is threatening our beloved NHS. The previous Labour govt had to spend billions to bring the NHS up to modern standards after years of neglect under the previous Tory admin. History is repeating itself" - Morel D'Souza, Kent