The world into which the NHS was born no longer exists. The six decades that separated the premierships of Clement Attlee and David Cameron witnessed, to sum up the argument of previous chapters, a transformation in the social, economic and political environment of the NHS. The industries nationalised in the Attlee years have been sold off. Britain’s class and industrial structure has changed dramatically; the new economy is based not on digging coal or building cars or ships but on services and information technology. Real incomes per head have more than doubled: the era of post-war austerity has given way to a flamboyant consumerism, dampened but not extinguished by a prolonged recession.