Can the NHS cut costs without substantially damaging the quality of health care? No

For NHS clinical staff, cutting costs is a way of life. When I was a final-year student in 1970, extra beds were squeezed into the middle of the wards. When I was a consultant in the 1980s, the financial formula was simple: your department’s budget is the same as last year’s, minus 2%. Through good times and bad this mantra has never changed, except that “department” is now “team.”

So my first reaction was that the coming lean years will make little difference. Writing this article, however, made me face facts. Eighteen per cent of government spending goes on health—second …