NHS England should not “become an agency that begs for more money for business as usual”, Sir Malcolm Grant has said.

Several commentators have suggested the NHS would soon need more funding to pay for increasing demand and the maintenance of care quality, while efforts continue to make services more efficient.

Sir Malcolm acknowledged that “if there’s [economic] growth it would be realistic to assume some proportion could be assigned to healthcare”.

But he told HSJ: “I don’t think it’s appropriate to start talking about additional funding until we’re absolutely clear we’re best investing the funding we’ve got.

“I don’t want NHS England to become an agency that begs for more money for business as usual − that’s absolutely not our function.”

Sir Malcolm also said the independent NHS board should consider the risk of the “needs of our ageing population” being “disproportionately charged to a younger generation”.

He said he was “rather taken with the proposition that each generation should pay for its own healthcare”.

He also said: “We’re not best investing resources in the best interests of patients at the moment.”

In the past the NHS had “tended to invest very heavily and rightly in new technology and pharmaceutical products and new hospital premises,” he said. “We will be wishing to see some rebalancing in coming years, in relation to public health and prevention.”

Sir Malcolm said: “What I don’t want is any talk about rationing or introducing co-payments, if government wants to get to that point in due course that’s a different issue.”

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