All historical work is defined by the present. With an end date in the 1990s and with many areas of post-war health experience and policy as yet unresearched, the conclusions to be drawn here must be even more contingent than is generally the case. This book has encompassed health at three levels – patterns of health, formal health services and areas of health policy, distinct from services. The conclusion will touch on all three. The focus in this book is on the British experience. How did Britain compare with patterns in other industrialised countries and their health care systems? Gray (1993) has pointed out that some issues affected all countries in the postwar period. The long period of unprecedented economic growth after 1948, accompanied by expansion of welfare provision, was interrupted by the oil price rise of 1973, which led to deteriorating economic growth and welfare policies under increasing strain. The way in which Britain coped with those pressures differed significantly from other countries. Gray's calculations show that in all OECD countries, formal health care continued to take an increased share of GDP. But most of that real increase in spending was a reflection of individuals making more use of health services. Population change and the rise in the proportion of the elderly were of relatively minor importance. Rates of use had risen for a variety of different reasons; in part through the role of technology, in part because of increased expectations (Gray, 1993, pp. 181–2). This pattern of growth slowed in all countries in the late 70s and 80s.