Tough Times, Tough Choices

The NHS faces an unprecedented financial dilemma: the supply of funding is struggling to match the growing rate of demand for healthcare. 


We have so far avoided the conversation needed with the public about how the NHS should confront these pressures. This report addresses this 'missing dialogue' by being open and honest about NHS finances and the tough choices ahead.


This report sets out options, not solutions. These choices are not pain-free and some may prove too difficult to swallow. The public will be better placed to understand and engage in a national debate if we are open about what happens, where, and why.