With a third of health authorities in debt this was welcome honesty. Doctors always say there is but recently their cries of anguish have hit higher decibels. If we want to improve our low standing in the international health league then tackling poverty, smoking and unemployment gets a bigger bang for every buck spent. But politics is not rational. The reality is that if the NHS doesn't get more money the privatisers will win by default.
Public demand has to be met even if social scientists know it means spending money less well.
It shouldn't be hard to persuade the middle classes to hang in there, with middle-class America crippled and immobilised by their health insurance bills. Any shift from public taxation to private insurance will cost everyone more without delivering more. But there comes a level of NHS underspending when people will stop believing it. Milburn was surprisingly honest about the need to raise taxes to pay for it. Then, tentatively alighting like a butterfly on the phrase, he floated the idea of a new hypothecated NHS tax.