Despite the Conservative Party having promised to increase NHS spending by £8 billion a year during this parliament – the minimum demanded by its managers – we learn of a crisis within the institution that promises a financial shortfall of £20 billion by 2020-21. Without (so far) any consultation, the NHS proposes a massive reorganisation that could include hospital closures and cuts, and these could start within months, just as the NHS suffers its winter overload.

Why have things come to this? According to Government figures, the £437 million spent in the first year of the NHS’s existence in 1948-49 is equivalent to £15 billion today. Yet the UK total spent on the NHS is now £116.4 billion, £101.3 billion of which is spent in England. The population is nearly a third larger than in 1948-49; we are 64 million people against the 50 million at the 1951 census, thanks not least to the last Labour government’s mass immigration policies and the EU’s refusal to let us control our borders.

Yet this population growth cannot account for such an enormous real increase in spending. The problem is that the NHS is doing things its founders never envisaged.