First, good move  on halting those Darzi centre builds: they were inefficient, and unnecessary.

Further cuts are quite easy to make without impinging adversely on patient care:

Connecting for Health (very expensive, unnecessary, inefficient)

All managers monitoring 4 hour waits in A and E (scrap the target while you’re there), managers monitoring junior doctors hours, and managers attempting to manage MTAS (see Remedy UK to discuss)

All the stuff about ‘patient centred’ and ‘patient led’ and ‘patient choice’ in the NHS – a lot of unnecessary advertising, focus groups, and tat (pens, shopping bags and similar freebie rubbish) when the whole point about the NHS always has been patients

Every induction day that includes the words ‘teambuilding’

Every  training day that does not include necessary and evidence based education: i.e. no more paying for staff to attend such gems as change management study days/courses contain ‘all you need’ to know in PR and marketing of hospitals

Stop all roles for management consultants

Get rid of every PFI contract possible, and do not take any more on

and please let doctors make referrals necessary for good clinical care. The silliness that means that consultant  A cannot refer to consultant B across the corridor without asking the GP to do if for him invites delays and error, and is deeply deprofessionalising

finally: think about getting an Independant NHS Board to take politics out of the NHS equation. The public can vote for the political spending  they agree with, and then a professional, evidence based, independent, transparent and compassionate Board can make the most cost effective decisions on how to spend it.