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Should NHS funding be ring fenced? Yes

BMJ 2010; 341 doi: (Published 17 August 2010) Cite this as: BMJ 2010;341:c4350
  1. John Appleby, chief economist
  1. 1King’s Fund, London W1G 0AN
  1. j.appleby{at}

    John Appleby argues that the alternative to ring fencing is too painful, but David Hunter (doi:10.1136/bmj.c4354) believes the focus should be on wider factors contributing to ill health

    If there’s one thing economists agree on it is the fact that the hole in the public finances—currently around £86bn (€103bn; $136bn), nearly 6% of the United Kingdom’s gross domestic product1—needs to be filled. For deficit deniers, the reason this needs to be dealt with is that left unchecked the hole will get bigger and the consequences of that would be catastrophic for the UK economy. The problem is that a big part of the deficit is structural and will not be automatically repaired as the economy grows. To resume normal service, the thing that economists disagree about is how and at what speed to fill the deficit hole.

    However, the decision has been made, and the chancellor’s emergency June budget set out an eye watering combination of public spending cuts and tax increases over the next four years as part of a strategy to deal with the …

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