A government claim the NHS is enjoying its "best year ever" has been attacked by nursing leaders and opposition MPs.
Senior hospital nurses said they did not have enough staff
Health Secretary Patricia Hewitt made the assertion in a BBC Radio Five Live interview in which she said patient waiting lists were at an all time low.
The Royal College of Nursing suggested 13,000 NHS posts were set for closure in England and said nurses and patients would be surprised by her description.
Tory leader David Cameron said the NHS faced a government-created crisis.
The NHS is facing a financial deficit of more than £600m with some 7,000 job losses having already been confirmed.
The Liberal Democrats have said the true number of job cuts could be even higher than the RCN estimates but Ms Hewitt has denied such claims.
The RCN surveyed 660 hospital-based senior nurses ahead of its conference starting in Bournemouth on Monday.
Some 45% said there had been redundancies or a reduction in nursing posts where they work.
Nearly 60% said they did not have enough staff to give their patients the standards of care they would like.
The RCN also surveyed 260 community nurses, such as ward sisters. Two thirds said they were under too much pressure, with 40% prepared to leave their current job if they could.
The findings come as separate RCN figures on job losses indicate that 13,000 posts have been identified by NHS managers to be lost since October last year as trusts struggle to save cash.
"Real patients and real nurses do not experience this as the best year ever," said Dr Beverly Malone, general secretary of the RCN.
"Patient services are being cut, nurses and other NHS staff are losing their jobs.
"If this is the best year ever, I dread to think what a year worse than this could look like."
Ms Hewitt denied that cuts in the NHS were due to pay rises for staff in excess of what was planned.
"There is a minority of organisations who have been overspending and that is because, in most cases, they have not adopted the best practice, like more daycare surgery, they've not organised their services as efficiently as they could," she told ITV's Jonathan Dimbleby programme.
She said "so-called job cuts" in recent weeks mainly affected agency and temporary staff and were reducing a "very inefficient and wasteful form of spending".
Ms Hewitt told the BBC: "Despite the headlines, actually the NHS has just had its best year ever.
"We have just come through one of the coldest winters for decades and we haven't had any of the winter bed crises. We got the waiting times down to the lowest level ever."
Conservative leader David Cameron told Adam Boulton on Sky News the government had "mismanaged" the health service.
"In the last month there are, I think, 9,000 people who have been threatened with losing their jobs in the NHS, we've got hospitals threatened with closure in the NHS, we've got the chief nurse saying that the system isn't working and that patient care is suffering," he said.
"We shouldn't over-use that word, but there is a crisis - these levels of redundancies, these levels of closures.
"It's a crisis that was pretty much manufactured in Downing Street."
Liberal Democrat health spokesman Steve Webb said the NHS was "over centralised and mismanaged".
"It is no good for the health secretary to pretend that care does not suffer when doctors and nurses are losing their jobs," he said.
Union Unison, meanwhile, is expected to announce support this week for its hospital staff members who may decide to take industrial action over cuts.
The Department of Health acknowledged it had underestimated the financial impact of new contracts for nurses and consultants by £310m but said the figure needed to be set against an overall annual NHS pay bill of £30bn.
Pay reform had been part of a "significant success story" in the NHS which had been recruiting, retaining and motivating record numbers of staff in order to cut waiting times, a spokesperson said.