The Wanless report is a pioneering effort—with a few omissions and errors

Seemingly on the edge of financial shipwreck not so long ago, the National Health Service is now sailing on a springtide of money, promises, and hope. Mr Gordon Brown, chancellor of the exchequer, has added an extra billion pounds to swell an already unprecedented rate increase in the NHS's budget. Mr Tony Blair, prime minister, has reiterated the British government's commitment to achieving the average level of spending in the European Union. The great unmentionable, tax increases to fund the NHS's growth, has appeared on the agenda of political debate.

So why are the corridors of the NHS not ringing with the hosannas of grateful staff and patients? One reason is scepticism about the government's ability to deliver. Achieving the government's spending target depends on Britain not becoming a casualty of a global economic recession. Moreover, uncertainty is compounded by controversy about just how many more billions will be needed to achieve the target.

But there is a more fundamental reason for not being …