The NHS was created over 70yr ago. Healthcare was simpler then; mostly hernias, fractures , etc. Medicine has since advanced beyond recognition. IVF, liver transplants etc, are routine. Future spending on healthcare, as a % of tax revenue can only increase, squeezing other government spending. As a Dentist , I will concentrate on the dental aspects of the problem. NHS Dentistry has always been a sensitive political issue. Successive governments of every party have shied away from major cuts. The trend has been to reduce access and therefore cap the spending ,possibly in the hope that it would wither away without any political price being paid. Currently, patients on welfare have free treatment subsidised by the middle- classes who are abandoning the NHS for the private sector. How long before political support for it ebbs away? In parallel with the reduced access, the regulatory body, the GDC, has instituted ever higher standards ,actively encouraged patients to complain ,with punitive sanctions on Dentists who are found to have breached regulations. The result is a professional exodus from NHS Dentistry and into the private sector, further reducing access. The Covid pandemic, as in so many other facets of life, has bought the problem into sharp focus. NHS dentists, terrified of being sanctioned for treating desperate patients without the necessary PPE, ventilation fallow time etc simply shut down and advised patients by telephone to contact yet-to-be -set -up urgent dental care centres or take analgesics. A&E departments in hospitals were swamped with patients seeking relief from simple toothache. The media was rife with reports of patients self-extracting their teeth. The less regulated private sector offered treatment to those who could afford it. Our challenge is to keep to the vision of the founders of the NHS and restore a basic accessible sustainable service..