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This briefing provides an update to the question \"where's the money going?\" It analyses new data recently released by the Department of Health and reveals how much money is absorbed by higher pay and other cost pressures and how much is left over for other developments such as reducing waiting times and other government priorities. 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It aims to set out the policy issues, history and consequences surrounding recent government moves towards promoting choice for patients in the NHS, and to identify necessary limits to choice in  a public health care system as part of a general critique of choice.  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Five years on, The King's Fund has commissioned Sir Derek to undertake a retrospective review of NHS spending. Real spending on the NHS has increased by nearly 50 per cent in that time. This report looks at where that money has been spent, what it has achieved, whether government policy has promoted effective use of the resources, and what needs to happen next. 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