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I'm waiting for the next headline which will be a 90bn funding gap by 2030.

The wider point is this:

People either want their families to die earlier from preventable causes, or we need to find a way to pay for the alternative.

At a system level more can be done to get efficiencies in treatment, but unlikely to halve the costs per treatment in real terms, so efficiency isn't the whole answer.

The only thing missing from this public discourse is the contribution of prevention and engagement. Wanless did it so well.

Surely time for our national leaders in public health to make their case for something more bold and radical. I cannot believe languishing in the obscurity of councils making cuts is the answer - but who will provide the real voice, and the data to back it up?

Mr Appleby, the stage is set.