Austerity Budgets

The UK prison doctor Theodore Dalrymple tells about what austerity budgets look like in Britain. He knows the health service best, and explains the counter-intuitive effects.

Unfortunately, it does not follow from the existence of immense waste in the public sector that budget cuts will target that waste. After all, most of the excess is in wages, precisely the element of government spending that those in charge of proposed reductions will be most anxious to preserve. It is therefore in their interest that any budget reduction should affect disproportionately the service that it is their purpose to provide

This is not mere theory; he describes the practice too:

I have seen it all before, whenever cuts became necessary in the NHS budget, as periodically they did. Wards closed, but the savings achieved were minimal because labor legislation required the staff—the major cost of the system—to be retained. Surgical operations were likewise canceled, though again, the staff was kept on. To effect any savings in this manner, it was necessary for the system to become more and more inefficient and unproductive. It was as if the bureaucracy had reversed the cry of the people at the beginning of Lewis Carroll’s Sylvie and Bruno, "More bread! Less taxes!," replacing it with "More taxes! Less bread!"

The implications are obvious.

Parenthetically, kudos to a man who can cite Sylvie and Bruno. It is not as good as the "Alice" books, but it is worth reading nonetheless.