Demand for health services has outstripped the capacity available to meet it since the foundation of the National Health Service (NHS). Each new generation of politicians discovers this afresh – although their response is conditioned by their own particular ideological standpoint.
Under the current government, significant efforts have been made to find the funding to bridge the gap between supply and demand so ably quantified by Derek Wanless.2 Despite the controversy over the impact of that spending, it is hard to disagree that it has had a transformative effect on waiting lists; on the NHS estate and on the treatment of conditions for which National Service Frameworks (NSFs) have been developed.
However, in reality, the increase in funding has only allowed the NHS to ‘catch up’, in Wanless’ phrase, raising health spending to a level of Gross Domestic Product (GDP) similar to that of our European neighbours. The challenge now is how the NHS will ‘keep up’. The generous above-inflation increases have tended to keep the question of long-term
sustainability off the front page, but we can expect to again hear the claim being made that the core promise of the NHS cannot be delivered in a modern society.