Richard Douglas, Department of Health director general of policy, strategy, and finance, has reportedly said that the drive to find further efficiency savings in the NHS will continue after 2015,1 with the total savings rising from £20bn (€24.6bn; $31bn) to a possible £50bn by 2019-20. His comments are a startling admission of the long term impact on public services of the global financial crisis and ensuing recession.

But perhaps it should come as no surprise. Firstly, economic recovery has been slow to the point of stagnation. According to the National Institute for Economic and Social Research’s “recession tracker” (www.niesr.ac.uk), the UK economy is still four percentage points below the last peak in the economy—over four years ago—and …