In his famous report of 1942, the economist and social reformer William Beveridge wrote that World War II was a “revolutionary moment in the world’s history” and so a time “for revolutions, not for patching.” The Beveridge Report outlined the welfare state that Atlee’s government would go on to implement after 1946, instituting, for the first time, a national system of benefits to protect all from “the cradle to the grave.” Its crowning glory was the National Health Service, established in 1948, which provided free medical care for all at the point of delivery. Since then, the welfare system has been patched, beset by muddled thinking and short-termism. The British government spends more than £171 billion every year on welfare—and yet, since the Beveridge Report, there has been no strategic review of the system, compared to other areas of government and public policy, which have been subject to frequent strategic reviews. Reform of the welfare system need not mean dismantlement, Frank Field and Andrew Forsey argue here, but serious questions nonetheless must be asked about how the welfare state as we understand it can remain sustainable as the twenty-first century progresses.