On 16th January 2000 Tony Blair was interviewed by Sir David Frost. In what was described as the most expensive breakfast in British history, the PM announced that spending on the health service in the UK would rise, over five years, to the European average. 

All the evidence is that this public commitment had neither been costed by the Department of Health nor cleared with the Chancellor of the Exchequer.

Over the next few hours that Sunday, the Department’s Chief Economist, Clive Smee, tried to work out with a calculator at home just what the cost would be. 

But in the March 2000 budget extra money was found for the NHS on condition that the service and the professions ‘modernised’ themselves.  Burdens on GPs might be reduced by NHS Direct and walk-in clinics; GPs, dentists, opticians, pharmacists and physiotherapists might group to take on more hospital work and old people might move out of big hospitals to convalesce in smaller ones freeing the main hospitals for acute care. 

It was sad that although massive resources soon became available, the same money was spent simultaneously on different policies emptying the kitty and committing future resources on salaries negotiated in a disastrously cack-handed way. The author, when negotiating GPs’ salaries a decade earlier, was associated with an overpayment of some 2%, an achievement put in the shade by his successors!