This report, Mind the Gap: Sustaining Improvements in the NHS Beyond 2006 , makes for a good read.

Aficionados of healthcare will recall that back in 2002 the British government announced plans for health spending to rise annually by 7.2 percent (in real terms) up to 2007-08. This means that by the next financial year the government will be spending some £110 billion pounds of taxpayers money on state health and social care.

Now, in detailing key NHS reforms between 1997 and 2006, the report not only goes on to analyze the likely progress and impact of further reforms between 2007 and 2015 but, crucially, it evaluates the need for significant financing reform after 2008.

In pointing out that people’s expectations of healthcare are continuing to outpace what the state can afford the overall conclusions makes for powerful reading. For it suggests that the NHS is heading towards a 10% funding shortfall by 2015 and that capital expenditure will be the first causality. It points to continuing cuts in number of staff, constraints on wage and salary levels, and even a return to the waiting list levels prior to the proactive involvement of the independent sector four or five years ago.

The good news is that it suggests that co-payments and a range of new private funding schemes might well be a way forward.