The NHS budget will rise by 0.1% a year in real terms over the course of Parliament but key health promises have been abandoned or could be watered down.
Some pledges made by the previous Labour government have been scrapped, including expanding free prescription entitlements for people with long-term conditions.
One-to-one nursing for cancer patients and the promise that patients will only wait one week for cancer test results will also "not be taken forward at this stage".
Before the election, Prime Minister David Cameron and Health Secretary Andrew Lansley promised a £200m-a-year fund for cancer drugs.
Today's review said the fund would be "up to" £200m a year but no final decisions have been published.
It comes after Lord Howe said in July that £200m was an "aspirational figure".
A spokeswoman for the Department of Health said: "Following today's spending review settlement we will be shortly setting out the detail for the funding of the cancer drugs fund which will commence from April 2011, and will be consulting on how it will operate."
Overall health spending will rise from £104bn this year to £114bn by the end of the next four years, Chancellor George Osborne (pictured) said today.
He promised an expansion of talking therapies for those with mental health problems and funding for priority hospital schemes.
Social care will receive an extra £1bn a year from NHS funds as part of an overall £2bn of extra funding every year by 2014/15 to support social care.
John Appleby, Chief Economist at The King's Fund, said: "The net result will be a reduction in the NHS's purchasing power.
"This places even greater emphasis on finding the £20bn in productivity gains targeted by the NHS's chief executive – the status of this has moved from an ambition to a commitment.
"The £1bn increase in grant funding for social care could provide some respite for hard-pressed local services and buys time while the Dilnot Commission works on a long-term funding solution.
"But this money is not ring-fenced so there is no guarantee it will be spent on social care."
Nigel Edwards, the NHS Confederation's acting chief executive, said the settlement "is as good as the NHS could have hoped for under the circumstances".
But he added: "Even with this settlement, the NHS faces a potent cocktail of pressures and we will have to work very hard to ensure the impact on services is minimised."
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