The Health Secretary has blamed high numbers of flu cases, Covid-19 and Strep A fears for the particular pressures the NHS faced over Christmas.

Steve Barclay’s comments come as senior doctors say the NHS is on a knife edge, with many A&E units struggling to keep up with demand and trusts and ambulance services declaring critical incidents.

Mr Barclay recognised the situation is not acceptable but attributed the “particular pressures” over Christmas to “a surge in flu cases, Covid cases and also a lot of concern around Strep A”.

He told broadcasters: “There’s £500 million of investment this year going into tackling the pressure in terms of social care.

“So we’re putting more funding in. We’ve got more clinicians, we’ve got more staff working in the NHS.

“Of course there’s a range of factors that we need to do. There’s been particular pressures over Christmas because we’ve had a surge in flu cases, Covid cases and also a lot of concern around Strep A.”

Mr Barclay also said the Government is focused on freeing up hospital beds and creating more capacity as that will relieve pressures on A&E and will ensure ambulance handover times are reduced.

He said that as a result of Covid, people have been more reluctant to go and see their GPs, adding: “That in particular has had an impact on cardiovascular risk.”

Mr Barclay added: “There’s other factors as well in terms of the backlogs on operations.

“Yes, it’s important that we get the ambulances to people quickly as well, but there’s a range of factors that have played in, particularly into those cardiovascular deaths, which is the prime issue when we’re looking at the challenge in terms of excess deaths.

There’s been particular pressures over Christmas because we’ve had a surge in flu cases, Covid cases and also a lot of concern around Strep A

“So, this is something the chief medical officer, the NHS medical director have been looking at very closely.

“It is why we are so focused on getting the people out of the hospital who don’t need to be there because that in turn will speed up the ambulance handover delays and get those ambulances back out responding to calls.”

Asked why he will not give NHS staff a real-terms pay increase given the record number of vacancies, Mr Barclay said the Government is “focusing the funding on to the operations backlogs, for example, getting more diagnostic hubs in place, getting the surgical hubs that we are rolling out, getting the backlog from the pandemic reduced”.

Work and Pensions Secretary Mel Stride also called for “pay restraint across the public sector”.

He said: “We have huge sympathy for nurses, who do an extraordinary job, day in day out, tirelessly up and down the country, but nonetheless, to be seeking 19.2%, which is 5% above a level of inflation that is now falling, I am afraid it is unaffordable.”

Asked whether it is time to sit down and talk to the union leaders about pay, Mr Stride said: “The more general point here though, is that we have to have pay restraint across the public sector.

“Now, with the nurses they were treated as a special case. They got a 3% pay rise during the period when (the) public sector generally had a pay freeze.”

It is painful and infuriating to be in this position - especially for patients and for our members who are struggling on the front line every day

He added: “So, we have done what we can, but the substantive point is that if we don’t control inflation, if we allow public sector pay to run away with itself, what we will end up with is a kind of wage price spiral phenomenon, which is very difficult to get out of once you get into it.

“And that will impoverish all of us because inflation will be running so high, particularly people like pensioners and those on fixed incomes.”

Ambulance staff are set to walk out on January 11 and 23 in a row over pay, while nursing staff will strike on January 18 and 19.

Royal College of Nursing general secretary and chief executive Pat Cullen said: “We are seeing A&E in a dangerous state, social care overloaded, primary care suffering and staff truly broken.

“The Government cannot blame the pandemic and other winter pressures for the crisis unfolding before our eyes – this has been a long time in the making yet the Government has consistently ignored warnings.

“It is painful and infuriating to be in this position – especially for patients and for our members who are struggling on the front line every day.

“One of the root causes is the ever-worsening workforce crisis, with nurses leaving in their droves because of a decade of real-terms pay cuts.

“Without enough staff, patients will never be safe. Yet the Prime Minister and his Government continue to refuse to even meet with us to talk about pay.”

Unison deputy head of health Helga Pile insisted the “NHS is on its knees like never before”, before adding: “The Government’s failure to deal with the workforce crisis is at the heart of the problems harming patients every day.

“The Government must stop buck passing. Years of neglect are to blame. The way to begin fixing this mess is an immediate boost to NHS pay to stop skilled staff leaving.”