NHS boss sets out his stall for Theresa May

Not much has been heard from Simon Stevens since the referendum result. But now the head of NHS England has set out a detailed wish list for the re-configured Conservative government.

In a newspaper article and at a parliamentary hearing, he has given the new occupants of Numbers 10 and 11 Downing Street something to ponder before the start of the parliamentary recess.

Writing in the Daily Telegraph he came up with a new version of holding out the begging bowl.

Patients might be surprised to hear that the NHS chief believes that some GP practices and hospital facilities are in "overcrowded and clapped-out buildings in need of a makeover".

With a thinly disguised swipe at ministers he said that to balance the books, billions of pounds of capital investment was being switched into day-to-day running costs.

He later told MPs on the Commons Health Select Committee that resources for investment were "very constrained" and it was an "open question" whether the demands across the NHS for maintenance funding could be met.

NHS chiefs are not usually known for giving the chancellor advice on public sector debt management.

But that did not stop Mr Stevens suggesting that with government borrowing costs the lowest since the Napoleonic Wars, now was a good time to raise money for an NHS 70th birthday public fund to invest in health infrastructure.

Health think tanks have been warning in recent weeks that the NHS in England will struggle to get by on current budget plans in the face of rising demands for patient care.

Mr Stevens told MPs that the extra money allocated by former Chancellor George Osborne for this financial year would make a "big dent" in hospital deficits.

But he pointed out that the spending review had "frontloaded" money for the NHS and that the financial picture would become tougher from 2018.

Extra funding needed

In other words, he was clearly leaving open the possibility that extra funding would need to be committed closer to the general election.

Simon Stevens

The head of NHS England was questioned on the Brexit effect on the NHS.

He refused to be drawn on whether he expected to see any of the £350m per week which Leave campaigners had claimed would be saved by the UK government when membership of the EU ended.

NHS staff from other EU countries should be given assurances about their status by the government and "the sooner the better", he said.

There is clearly some frustration among health leaders in England that the childhood obesity strategy appears to have been shelved again.

The arrival of a new prime minister seems to have delayed final approval of the much heralded plan which has already been postponed twice.

Mr Stevens said there were "well worked up" proposals which were "ready to roll".

In his newspaper article he said an activist strategy was "urgently needed".

So Simon Stevens has marked the cards of Theresa May and Philip Hammond. Some in Downing Street might see this as presumptuous.

Ministers have argued consistently they have given the NHS all the resources which have been requested.

But Mr Stevens is signalling that something more will be needed if the NHS can deliver satisfactory care in 2020, the election year.