At the same time, the need for higher spending climbs remorselessly. Derek Wanless's report on the NHS, published today, shows how much extra cash will be needed to build the health service. Similar exercises for education and transport would also show that these need huge extra sums - on top of the amounts that will be needed in the short-to-medium term to sort out Railtrack and London Underground, and replace student loans with a policy that voters in middle Britain will find more congenial. There is also the cost of combating child poverty and, since 11 September, the prospect of defence budgets having to rise, even after the terrorist crisis is over.