Viable funding options for the National Health Service in England.

Established in 1948, the National Health Service (NHS) in England was founded on the principles of universal coverage and a service free at the point of use. These principles are under threat with a funding crisis and a lack of clear political will to find a long term solution. This article reviews and explores three categories of options, looking forward, for delivery of more sustainable services. First, is for no additional funding, in which case patient expectations and the breadth of services offered would need to change. Second, is for additional public funding. Options include increased taxation, the formation of a hypothecated tax, amendment of current pension funding and or localized funding strategies. Third, is for additional private funds, including charges for utilisation, prescriptions or via incentivisation of private health insurance. These latter avenues however remain largely unpalatable and have noteworthy disadvantages.