It is often argued that the demands for increased healthcare expenditure arising from an ageing population, advancing technologies, and increasing expectations, warrant higher healthcare budgets. Professor Stephen Birch argues that this reactive approach is not sustainable, and that the perceived mismatch between resources and demand is due to poor health service planning. In this briefing, based on an OHE lunchtime seminar, Professor Birch presents a framework to re-focus planning models on population needs.