Over the past few weeks, a number of trusts and health authorities have raised concerns publicly about their financial situation. Until this week, it might have been possible to play those worries down - a case of the September jitters, so when those 'winter pressures' hit, managers can say, 'I told you so'.
But with edicts issued this week that spending in key areas such as research and development must be frozen in order to shift cash into clinical services, there is clearly an acknowledgement from the centre that there still is not enough money in the NHS.
Trusts claiming to be cash-strapped have so far simply been reminded that they have had a bumper payout, and should be grateful and get on with it.
It seems clear now that even that biggest-ever cash allocation is not yet enough and, with NHS inflation running at up to 7 per cent, the health secretary should be making a vigorous case to the Treasury to prise open the coffers just a little further.
Simply moving money around the service, rather than putting more cash in, is no way to avert those winter crisis headlines or even a complete collapse in confidence in the NHS. A government which has asked to be judged above all on service delivery can illafford a charge of complacency.