The problem the Tories have run into on the NHS is that they are faced with a difficult opponent in doctors. Doctors are the Tory worst nightmare - well organised and disciplined into a union, with residual loyalty towards New Labour who gave them the best deal on pay and conditions in history, who have a strong level of public support (its hard to sell to the public the idea of doctors being workshy leftists), and a level of income and education that gives them a strong public voice and also means they operate in traditional Tory social circles.

Lansley's whole selling point at the start of the NHS reforms was that these reforms would mean doctors made the decisions, not 'bureaucrats and politicians', because when it comes to patient care, 'doctors know best'. So now the doctors are picking holes in the proposals it is difficult to backtrack and say that actually bureaucrats and politicans are right and they are wrong.

Another problem with the proposed cuts is that the mythical "middle tier management" who were going to be the target of all cost savings just don't seem to exist in big enough numbers to provide all of the targeted cost savings and its becoming increasingly apparent in both the NHS and police that front line services will be affected and are already being affected (Google Pontefract A&E services), despite absolute assurances that they wouldn't be touched and that it would be "unnecessary" bureaucrats that would go.

Its going to be an interesting summer ...

well said sally

Some interesting graphics showing how productivity as compared to wealth distribution has changed over the years. The study was based in the US but I doubt UK figures would differ wildly.

I have always said our civilisation peaked ca. 1968 - 1970. The graphs show that the wheels feels off right at the beginning of the 1970s. There were a whole host of factors behind that - the obvous ones like domestic strife, the oil crisis etc; but I think in an overall analysis the thing that we overlook is the rise of new competition. Japanese manufacturing really started to impact on British firms then, as did Italian's, etc in the field of white goods. Since then we have seen wider competition from the Far East, etc. This, rather than any domestic policy, explains why wages for the lower half are reducing in real terms. Those for the higher earners rise because there is less competition (currently) in sopisticated, intellectualised fields. Our huge problem comes in about 10 years time when China is churning out more creative and hihly trained people in the millions. Then we will know what austerity truly is.

I've never really been able to fully get my head around the fact that the Tories talk about freeing doctors and the police from paperwork etc. to get on with treating patients and catching villains, yet seem to despise the managers put in place to handle the paperwork etc. that theoretically allows doctors to not have to be accountants and policemen not have to be administrators.

That's because in an ideal tory world there would be little, if any paperwork. The police would catch a criminal, then take him straight to court, where he would either be found not guilty and released or more likely: found guilty and carted off to The Clink, the workhouse, a prison hulk, transported to the colonies or simply taken round the back of the court, strung up and hanged. Simple innit?

Because its easier to give the impression that these career politicians, the ones with precious little experience of working outside of a Westminster internship, have all the answers and the answers lie in a tier of unnecessary management that they, and only they have spotted and once they get rid of these people who only consume budget and have no effect on output or service, then all will be well in the world, the fact that precious few of these management positions actually exist or that none of the politicians actually seem to have done any research and can point at one of them seems to escape everyone's attention.

It also helps the cause when its not actually you with blood on your hands but the Health Trust that you assigned the budget to, you spoke out on TV about how easy it was going to be to manage on 20% less budget this year but its not your fault that the Trust interpreted this into 20% less hours for front line staff and you had to close A&E every night at 6pm.

He will?

How does that work then, seeing as he's being paid his bonus in three-year deferred shares?

Not bad business: pocket nearly £1m worth of penny shares (they're currently being traded as junk), then in five years time, cash them in, he won't mind the CGT he has to pay on that lot. Or maybe he could just send them into an offshore trust and avoid any tax liability alltogether?

RBS Chairman gives up his share bonus Meanwhile, Cameron continues witrh his weaseling lies: The government said it would not block a £963,000 bonus, also in shares, for RBS chief Stephen Hester. Prime Minister David Cameron said it was up to Mr Hester whether he accepted the bonus. "That's a matter for him, that's obviously his decision." Mr Hester's contract at RBS - which is 82% publicly owned - was agreed by the last Labour government, Mr Cameron said And not to be outdone, Gideon has spoken to Stephanie Flanders: George Osborne has just told me the government will not vote against Stephen Hester's bonus as a shareholder at the April AGM. Ed Miliband had thrown down the gauntlet on this today, but the chancellor has declined to pick it up Pair of 2@s. Mebbe the commission that single mothers with pay on their CSA can be lumped into the RBS trough too?

RBS Chairman gives up his share bonus Meanwhile, Cameron continues witrh his weaseling lies: The government said it would not block a £963,000 bonus, also in shares, for RBS chief Stephen Hester. Prime Minister David Cameron said it was up to Mr Hester whether he accepted the bonus. "That's a matter for him, that's obviously his decision." Mr Hester's contract at RBS - which is 82% publicly owned - was agreed by the last Labour government, Mr Cameron said And not to be outdone, Gideon has spoken to Stephanie Flanders: George Osborne has just told me the government will not vote against Stephen Hester's bonus as a shareholder at the April AGM. Ed Miliband had thrown down the gauntlet on this today, but the chancellor has declined to pick it up Pair of 2@s. Mebbe the commission that single mothers with pay on their CSA can be lumped into the RBS trough too?