The start of renegotiation of the major staff contracts in the NHS – for consultants, GPs and the rest of the staff

The government has avoided this. Andrew Lansley has set up a review of financial awards for clinical excellence for doctors, but the major contracts will stay in place. This is despite the vision of decentralisation and local control set out in the NHS White Paper ‘Equity and Excellence – Liberating the NHS’.

Greater means testing of benefits

This has become the hot topic in government. Nick Clegg and Iain Duncan Smith are reportedly arguing – rightly – that greater means testing of universal benefits is a fair way to reduce public spending. The trouble for the government is the Conservative election pledges to protect child benefit, the winter fuel allowance and free TV licenses for the over-75s, which senior Conservatives may now be coming to regret.

New near-compulsory pensions to be reviewed

Steve Webb has duly announced the review, which will report on 30 September. The review will re-examine the costs and benefits of auto-enrolment. But the scheme also needs to be considered in the light of the public finance position. The ratings agency Moody’s has said that the financial crisis has brought forward the demographic crisis in public finances by 20 years, i.e the moment when the costs of health and pensions become unsustainable is closer than we think. Private saving needs to take more of the weight of welfare provision.

Outsourcing of civil service functions

The early spirit of the new government has defended the existing civil service. Speaking at a Reform conference in July, Francis Maude, the Minister for the Cabinet Service, said civil servants should be given more work as they would pick up capability from doing it. As a result, he said, “We will not only save a lot of money by the consultancy constraints we’ve put in place but we will also empower and encourage and re-motivate mainstream civil servants.” Francis Maude’s problem is that the capability problems in the civil service are very deep, according to the National Audit Office and the service’s own capability reviews. Stopping outsourcing is a false economy.

Cap on tuition fees

Remarkably, the debate has turned to a graduate tax (or graduate contribution, which is based on the principle that some students should pay for university according to their earnings rather than the cost of their courses). Higher fees would have the great advantage of making students price-conscious; they would put pressure on universities to change their methods and become more efficient. A graduate tax would remove that at a stroke.

The number of teaching assistants will fail

The debate on education funding has not happened. School spending will be protected in the coming year and will face lower cuts in the years ahead. The trouble with ring-fencing budgets is that the protected areas feel absolved from the need to reduce cost.

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