The NHS turns 70 next month, and it appears increasingly likely that the government is going to announce a health spending settlement for the next few years.
Health spending increases over the past eight years have averaged only 1.4% per year, compared with almost 4% between 1949 and 2009.
While the NHS has managed to do a lot more despite limited funding increases – activity on a number of measures is up considerably – there are visible signs of strain. In particular, high-profile national targets – for example the 4 hour A&E wait target – are being missed and do not look likely to be met soon.
While a consensus appears to be growing that health spending needs to increase, less attention has been paid to how the government will pay for it.