Health Secretary Jeremy Hunt admits in an interview with this newspaper today that the NHS is in turmoil. He tells Annabelle Dickson about his future plans.

Jeremy Hunt is clear. He would love another two years in one of the biggest jobs in politics for his unfinished business.

He wants to set out the bigger picture for our health service before we get down to the nitty-gritty of local hospital finances and ambulance woes.

By the end of this parliament (2020) the NHS will be looking after one million extra over-70s, and is already carrying out 4,500 more operations each day compared to 2010.

'I think there is a lot of turmoil in the NHS at the moment as we deal with those pressures and as we deal with Mid-Staffs [the hospital care scandal], which was a particular shock,' he said.

Commissioners, trusts, doctors, nurses and care workers alike would point to the vast and ever-growing deficits which are an immediate issue for the NHS.

An extra £10bn for the NHS from the Treasury ahead of the last election came with a commitment to make £22bn of efficiency savings – something Mr Hunt admitted will be a 'big challenge' now the 'low hanging fruit' has gone.

But he later added: 'I would say that in the long run – the next 10, 20, 30 years – we are definitely going to need to put more money into the NHS to deal with the pressures of an ageing population.

'In terms of what happens over the next five years, we were elected to put more money into the NHS but also to bring down the deficit.

'Why did we want to do that – we didn't want to be some hatchet-faced accountants, but we know if the economy grows, that will provide more money for our basic public services.

'I think that when we eliminate the deficit we need to see a step-change in NHS funding for some of the pressure we face. I do recognise we are going to have a tough period until then.'

One of the pressures on hospital budgets is fines. According to commissioner board papers, the Norfolk and Norwich University Hospital had to pay £13.2m last year for missing targets. Only £3.9m has been re-invested into the hospital.

But Mr Hunt claimed a fines system is 'perfectly reasonable'.

'If a hospital like the N&N is going to struggle to meet a target they should not sign up to it in the first place.

'We have to get into a system where fines are unnecessary because people are meeting commitments they signed up to at the beginning of the year. If you don't do that targets become meaningless as well,' he said.

But he suggested longer contracts could allow trusts to be more strategic about the way they provide services.

The pressure from the private finance initiative which paid for a new hospital on the outskirts of Norwich is also a big burden. The N&N trust spends nearly £40m a year on payments.

Mr Hunt said that while trusts should be looking at whether they could reduce the burden, his predecessor, Andrew Lansley, had looked at whether contracts could be renegotiated, or the debt could be made more bearable.

'The truth is that we have to live with what we've got. These are decisions that were made a decade ago. We are going to have to find a way to reduce the deficit because unfortunately these are contracts.'

For the health secretary, though, life in recent months has been dominated by junior-doctor contract agreements.

Strikes were averted, for the time being, after an agreement was reached which will be put to junior doctors to vote on.

Mr Hunt said he would be 'confused' if junior doctors voted against the deal negotiated by their union, and maintained the contract change is necessary to deliver a seven day NHS.

But he praised the professionalism of junior doctors.

'The great thing about NHS doctors is if my children needed to go to an NHS department – thankfully they didn't during the strike – I know they would be totally professional. They wouldn't think twice about it. That is who they are. That is the ethics of their profession and it wouldn't cross their mind.

'I don't think NHS staff have ever worked harder.

'It is particularly tough for those on the front line. But we do all share this vision of what we want the NHS to be, we have a good chance of getting there,' he added.