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In the report, ‘Demand for a new era: the future of health ', it argues that rising life expectancy, higher living standards and expensive new treatments will combine to massively increase patient demands.

But it adds that the last eight years of generous spending increases are over.

As a result, the health service will be ‘overwhelmed' by demand unless it provides better value for money. It calls for an economic constitution modelled on the BBC charter.

Reform criticises the government's resistance to reforms that allow commissioners to focus on local priorities, citing the imposition of extended hours and Darzi clinics.

It says that a new constitution would require them to instead focus on a small set of ‘patient-focused objectives', and demonstrate that any change would provide better value than existing services.

It also calls for improved financial information, in order to remove the ‘massive incentive towards hospital treatment'.

jonn.elledge@haymarket.com

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