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The most important issue in health is, of course, to recognise that there is no most important issue in health. How could one possibly choose between the evisceration of the NHS, the abandonment of social care, grotesquely widening health inequalities, the looming nightmare of antimicrobial resistance, or the incipient planetary catastrophe of climate change?

​Every year, hundreds of pieces of health and healthcare guidance are published for NHS and local authorities. Having worked for most of my career in national policy making I've written many pieces of - what I thought was useful - guidance. Now I’m on the other side as a CCG commissioner, I see how little of it is widely read or has an impact beyond the real enthusiasts.

They say the sequel is never as good as the original. My second Melting Pot Lunch, thankfully turned that on its head. Today’s question was posed by David Haslam (Chair of NICE), with his customary eloquence.

What exactly is healthcare trying to achieve? Will we know when we’ve got there? Professor David Haslam examines these questions and the values of our current health system in this blog on the future of healthcare.

Annual funding for the NHS is falling ever further behind increases in activity costs. The government’s promise in 2015 of an additional “£8bn” assumed heroic savings of £22bn over a five year Parliament, which health policy experts think unattainable. The NHS now has the biggest deficit in its history.

​No. Instead introduce a ‘participation income’. This is a taxable income transfer to all those who participate in society. Participation is broadly defined, including those who work but also those who care for children or the elderly and can include those who volunteer.

The NHS is no stranger to five or ten year plans. Today’s publication of the 'Five Year Forward View' takes its place in a lineage that includes 2009’s 'NHS 2010-2015: from good to great' and 2000’s 'NHS Plan', among a library full of other titles with similar echoes of communist tractor production.