It is impossible to contemplate the current state of the National Health Service without the nightmarish feeling that not just a once-in-a-lifetime, but a unique, opportunity is being squandered.

Since 1999, the NHS has enjoyed the longest period of sustained growth in its history. Expenditure has more than doubled in cash terms. By 2008, it will have doubled in real terms. Health expenditure over a nine-year period will have risen from about two-thirds of the European average to a figure that matches, or even exceeds, the European Union average in terms of share of national income.