The key questions for the NHS

Doctor with stethoscope Image copyright Thinkstock

Welcome to Hugh's Views - as the first health editor for BBC News it will be my topical take on all things health related.

Around Whitehall and senior levels of the NHS in England I am hearing the view that there needs to be a cross-party debate on what can be delivered over the next five years and beyond.

That might sound naive with a General Election looming, but there is a growing belief that the financial and demographic challenges require non-partisan discussion, with the public made aware of what can realistically be expected.

That was very much the theme of today's letter to The Times by some leading lights in the health world. The president of the Royal College of Physicians and two non-executive directors of NHS England are among the signatories.

They argue that pressure on health and social care budgets are such that difficult decisions have to be made over financing the service. While acknowledging the need for further efficiency savings in the NHS, they say that the next government will have to find new sources of funding - either from higher taxation or charging patients for some services. Without new money, they argue, there will have to be a review of what is available on the NHS.

The NHS has been providing care free at the point of use for 66 years. A recent report by the US think-tank, the Commonwealth Fund, said it was the most efficient and safest healthcare system out of 11 leading economies.

But there are major challenges ahead.

The population is expanding, demand for a wider range of drugs and treatments is growing and people are living longer.

Yet all main parties are committed to tight controls on public spending for a few years in the drive to bring down government borrowing.

What can the UK afford? What do we want from the NHS? Should the service do things differently? How should big health issues such as diabetes and obesity be tackled?

These are all big and important questions - and there are many more. I look forward to exploring what the answers might be,