The future funding of health and social care in England.

boomers. As beneficiaries of the Attlee settlement, we have enjoyed affordable health care, decent housing, free higher education and a generous welfare state. Notoriously, these are blessings that could be denied the next generation.1 The NHS is facing yet another funding crisis and social care is under increasing strain. The confusing border between the two has long been a source of administrative waste and frustration for users. Patterns of ill health, life expectancy, family structures, and medical technologies have changed considerably since 1948 when Beveridge and Bevan established the current system. A King’s Fund commission, chaired by the economist Kate Barker, proposes a new settlement fit for today’s circumstances.2 An interim report used five criteria to assess future options: equity, transparency, efficiency, the split between collective and individual responsibility, and affordability.3 The evidence suggests that the present arrangements fail on all of these criteria.