The new health secretary has promised the NHS will remain free at the point of use as long as she is “alive” as the service gears up for another difficult winter.

Victoria Atkins, who replaced Steve Barclay in Rishi Sunak’s most recent reshuffle, made the commitment while discussing the “unique” pressures the NHS faces every year.

“We have 11 million inpatients a year so the scale of the NHS is unique around the world,” she told Sunday Morning with Trevor Phillips on Sky News.

“It is also unique because of the very fact that our care is free at the point of use. And that will continue for as long as I’m alive.”

Her commitment came as the NHS continues to suffer acute pressures, including a waiting list of an estimated 6.5 million people at the end of September and a high number of staff vacancies.

The difficulties facing the NHS has generated questions about its future, with the British Social Attitudes survey finding that the British public is the unhappiest it has ever been with the health service – but that it still supports it in principle.

Ms Atkins admitted there would be a “winter crisis” in the health service over the coming weeks and months as temperatures drop and people contract more illnesses.

Politics news – latest: Ensuring NHS functions well over winter is the ‘absolute priority’, Atkins says

She said the government had started preparing for the winter with an urgent and emergency care plan and that, having met its target to recruit 50,000 more nurses, it was “beginning to meet” the target of 5,000 more beds in hospital in a bid to cut delays.

Asked about the fact that three coroners had written to her to warn that ambulance delays were already causing unnecessary deaths, Ms Atkins said she was “very concerned” but that 800 new ambulances would be brought into the service.

She also claimed that category two ambulance times – which cover urgent calls for problems including strokes, and demand a response time of 18 minutes – had already improved.

Sir Trevor read out statistics from NHS England which showed that in 2014, the total number of people who had to wait 12 hours for hospital admission after a decision had been taken to admit them was 489.

In October this year, the average number of people who had to wait over 12 hours stood at 1,440 – nearly three times as many, he said.

Asked what she would do to solve the problem, Ms Atkins said hospital discharge was key.

“What we are doing to address this is almost looking at the end rather than the beginning, because if we can move people out of the system more quickly, then the flow through the hospitals is much smoother and quicker.”

Elsewhere in the interview, Ms Atkins was asked about how the NHS would fill 121,000 vacancies if the UK looks to cut immigration, with statistics showing that in June this year 265,000 people in its workforce came from abroad.

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Ms Atkins said that while those from overseas who worked in the NHS were “incredibly important to the system”, “immigration as a whole is too high”.

Last week, figures from the Office for National Statistics showed that net migration hit a record high of 745,000 in 2022 – revised up from a previous estimate of 606,000.

Ms Atkins said the government’s long-term workforce plan will see more nurses and doctors in the UK trained and retained in the system.

“We are working across government to tackle immigration because we understand it’s of great concern, but we can do this in a way that protects the NHS,” she added.