The NHS appears to have developed its own variation on Parkinson's law (the one about work expanding to fill the time available). In the case of the health service, unanticipated expenses expand to use up money earmarked for growth and innovation (see news, pages 2-3). Let's call it Brown's law.
For the£500m that chancellor Gordon Brown expects health authorities and trusts to find to cover increased employer's contributions to the NHS pension scheme will come from what ministers call 'patient services' as surely as the bureaucracy they decry.
Amid general confusion about NHS finances - which by now must extend to ministers themselves, so often have they repackaged their spending plans - it is easy to lose track of what sums of this order mean. Here is a reminder.
The£500m is approximately four times the price of a new hospital, five times the sum the NHS stands to claim each year from insurance companies under the new road traffic accident charging scheme, and 17 times the cost of developing all 20 high street walk-in centres under the government's plans for NHS Direct.
It is also five times the amount the government estimates is lost by the NHS each year to fraud. Which may be appropriate, bearing in mind Mr Brown's failure to mention the effect of this purely 'technical' contributions change, even though, with uncanny prescience, he allegedly took it into account in the spending review.
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