At the NHS Confederation conference, Nuffield Trust director Jennifer Dixon offered the heretical view that the policy of tilting NHS spending towards public health is a mistake.

But this was not a plea to allow ever larger numbers of citizens to waddle and wheeze their way to an early grave.

Dr Dixon argues that the NHS acute care budget is under such high and increasing pressure that the service cannot afford to be primarily responsible for stumping up the cash for tackling public health. Instead every section of society - schools, business, local government, as well as health - should shoulder its share of responsibility.

The NHS has long understood the flaw in William Beveridge's belief that a national health service would experience falling demand as the population grew healthier.

With rising cost pressures from long term conditions, innovative treatments and drugs, and projected population growth to 65 million by 2051, it is difficult to see how the NHS could possibly be expected to meet those challenges and deal with prevention on the scale needed.

Dr Dixon's unexpected intervention in the funding debate should be discussed. Investment in prevention is too important to be funded by crumbs from the acute table.

For full coverage from the NHS Confedration conference, go to the news section of hsj.co.uk.

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