New Judge is correct inasmuch as the present model of the NHS is unsustainable both managerially and financially. One of the central problems, which are several/many, is that the institution has a certain mythical shape/form in the public imagination and politically it is a holy-cow totem. Every political party falls over itself in making promises in reaction to public clamour, while all the while knowing that the NHS is way past its "best by" date. For some decades now, sticking plaster has been placed on sticking plaster to the point where the original beast can hardly be seen under the pile - but that is very British and applies to virtually all aspects of state management because of the inability to make (and/or chronic fear of making) radical/serious improvements that properly aim for realistic solutions - meaning the classic British fear of change, better to muddle on somehow and pretend all is well. The last I recall, the NHS was somewhere in the very high teens on the list of international comparisons of effectiveness (cost and results for the population) of health services - all the while in the UK one hears/sees statements to the effect that the NHS is the best in the world. So what else is new ?