i'm joined now by tim gardner, a senior policy fellow at the health foundation.was december and possibly january so bad ? joining us. why was december and possibly january so bad? the nhs is clearly under enormous pressure at the moment. there are a number of reasons for that. we are living longer, but we aren't necessarily living healthier. there are more of us. demand for the nhs goes up by 4% per year. the government has increased funding for the nhs, but that hasn't kept pace with growing cost pressures. so, there are more patients using the service, there is the extra cost of new technologies and treatments, and filling staff shortages with costly agency staff is also a burden. particularly in winter, when the cold weather means that underlying health conditions can that underlying health conditions ca n flare that underlying health conditions canflare up that underlying health conditions can flare up and there is flu around, more respiratory disease, and at the same time there is more pressure on hospitals through more beds being lost to winter vomiting bug