Front-line NHS services in Birmingham and the Black Country are facing a £100 million funding crisis.
Primary care trusts have been ordered by the Government to make significant budget cuts over the next three years, throwing into doubt a drive to address obesity and teenage pregnancies and reduce inner city health inequalities.
The five Birmingham PCTs will receive £84 million less funding than they had expected, while Black Country PCTs have been told their budgets will be reduced by about £13 million.
Hardest hit is the Eastern Birmingham PCT, which faces a £6.3 million shortfall next year, £9.4 million in 2007/08 and £12.6 million in 2008/09.
South Birmingham PCT faces a £5.2 million shortfall next year, £7.9 million in 2007/08 and £10.5 million in 2008/09.
Health experts claimed the cuts would make it impossible for PCTs to deliver on Government pledges to reduce the amount of time patients wait to see their GP.
Total funding is still set to increase across the Midlands, but the money available to the PCTs will be less than was previously promised. The announcement by the Department of Health, less than two months before the start of the new financial year, attracted criticism from local authority leaders and MPs.
Paul Tilsley, the deputy leader of Birmingham City Council and a member of the South Birmingham PCT, said the cuts meant it was extremely unlikely GPs would be able to meet targets to improve the quality of life.
Coun Tilsley (Lib Dem Sheldon) added: "PCTs are in the vanguard of preventing heart disease, obesity and teenage pregnancies. It doesn't make any sense to cut funding."
Coun Sue Anderson (Lib Dem Sheldon), cabinet member for social care and health, said: "With reduced funding how can we prevent people in the centre of Birmingham dying, on average, seven or eight years earlier than people in the leafy suburbs of Sutton Coldfield?
"We are not going to improve the health of our citizens at all."
Birmingham Yardley MP John Hemming has asked for a debate in the House of Commons.
Mr Hemming (Lib Dem) said: "I have spoken to senior managers in Birmingham's PCTs and they say it is difficult to see how they can break even in 2006/07 without failing to meet waiting time targets."
Sophia Christie, chief executive of the North and Eastern Birmingham PCTs, said: "We are working to assess the position for 2006/07 and what action we will need to take to ensure that each organisation can still maintain financial balance.
"We understand that these technical changes are also having a significant impact across many areas of the country."
The funding change is a result of the Government phasing out a scheme called the purchaser parity adjustment.
This provided subsidies for regions such as the West Midlands which were under-funded in other ways.
Ministers have announced this is to be abolished more quickly than expected.
The decision is being seen as another example of the Government diverting public funding to London and the South-east at the expense of the West Midlands.
Mike Whitby, the leader of Birmingham City council, said: "We are being marginalised by London yet again."