> ‘Ask me my three main priorities for the NHS, and I tell you: efficiency, efficiency, efficiency.’ No government minister said this, at least not yet. Of course, the government wants quality too, but its war is on spending, and efficiency is its weapon. NHS spending power is set to remain stable at best for the foreseeable future. Unprecedented 4% productivity gains for at least 5 years are now demanded by the government.1 And this is in the face of a relentless increase in the demand for health care, throughout modern history, and across the world.2 December brought news of a rising UK population, and that across the globe we live longer but are sicker, so increasing demand for NHS care seems certain to continue.3 December’s National Audit Office (NAO) report told us that the NHS in England met its first year target mainly by plucking the low-hanging fruit. The NAO is doubtful about prospects for large year-on-year efficiency savings until 2015, let alone beyond. It also examined the government’s only …