The report published by the Institute for Fiscal studies and the Health Foundation clearly serves to show the challenge the UK NHS faces. This report is published at the same time as the current sharp focus on the rising costs of caring for patients suffering from degenerative conditions such as Alzheimers which brings a more human element to the issues we face. The forecast of £2000/ year extra needed per household in order to balance the needs of the current generation whilst being fair to the next generation is a stark figure and will surely cause concern amongst those who become aware of the study. Given such a figure, isn’t it time for an informed debate amongst the population to ensure everyone understands the real problem ? Given the NHS is such a large institution and revered so much by the general public shouldn’t we begin to look at a separate taxation system to fund it so everyone knows what they are paying into and what value they get ? How can the public (and next generation) be reassured that if general taxation rises without the monies being securely ring-fenced that it would be allocated to the NHS ? Who is to say any increase (and the report says 3.3% increase per annum is needed for the next 15 years in order to address the funding gap) will find its way to the front line NHS services ? This report highlights the needs of today and tomorrow and provides a clear indication of the need for long term commitment – a commitment which is difficult for politicians elected to office who, by virtue of the democratic system usually end up focusing on short term mandates and annual budgets. Given the size of the NHS the critical area to address has to be workforce stability.