The Department of Health (DH) faces an enormous challenge: how to meet ever-increasing demand from an ageing society while public spending increases no faster than inflation. And maybe less fast: last month's budget implies further public expenditure cuts, to meet the government's deficit targets.
The "solution" most often proposed is further below-inflation pay rises for NHS staff, more reconfiguration of hospitals and new ways of enhancing productivity. There is no alternative? Well, actually this time there is: but it involves a radical change of focus, a Whitehall shakeup, and some tough spending choices.
This week marks the first anniversary of the introduction of radically changed commissioning arrangements in the NHS.
These arrangements, which, through the creation of clinical commissioning groups (CCGs), placed clinicians in a position to lead decision-making for local health services, also saw the creation of commissioning support units (CSUs) to support CCGs and NHS England.
The NHS is facing the biggest challenge in its 66-year history and must radically change how it cares for patients in order to cope with intensifying pressures, the service's new boss has warned.
A budget squeeze combined with a growing demand for care driven by the ageing population means that "for the NHS the stakes have never been higher", Simon Stevens will say on Tuesday his first day as NHS England's chief executive.
Lord Warners suggestion of a £10 a month subscription fee to the NHS hasnt gone down well so here are five other ideas from history he could use instead.
Throughout Europe religious orders have provided the great majority of care to those too poor or sick to be able to pay for medical attention. Theyve dealt with every part of health care, from foundling hospitals for abandoned babies, to leprosariums for the shunned and contagious. In fact, Hildegard of Bingen, one of the most famous healers of the medieval period and author of books on natural history and medicine, was a nun. Nuns are notoriously cheap labour, and best of all hospitals can be run on a mixed funding basis with contributions from rich local benefactors, the church, and the state.