Matthew Swindells, former adviser to Patricia Hewitt when she was health secretary and now managing director (health) of consultants Tribal, said there was now little difference between Tory and Labour health policy.
He told the conference the worst election result for the NHS would be a hung parliament.
'Hard decisions would be put off. An absence of decision- making would be the worst thing. We cannot afford to put them off because the financial problems are coming quickly.'
Answers lie in pulling work out of hospitals and pushing it into the community, said Mr Swindells.
He said London district nurses who drove their way more efficiently around their patch managed to improve their productivity by 70 per cent.