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Rob you have raised a valuable point.

What will an acceptable figure of staff losses?

The next issue is how do we pay for the redundancies, have McK factored that in?

Also what will be the economic impact. If we go half the number of 67,000 people out of work at the same time.
Especially if you are targeting 30,800 bracket of £20,000 salaries bands 3. Given the Make up of the NHS this will mean around 75% of these people will be women. So we will expect to see child poverty on the rise too.
Doesn't that mean more health care needs as usually more disease....
Also how many additional people we will need to manage the complaints that will come in from patients?

The thing I am really confused about is that they are talking about cutting 28% of Community budgets but that will only mean that attendances will then go up at acute. Has any work been done on the circular flow of patients or is it just someone sitting with a calculator (which any idiot can do!).
Has a trend analysis been completed (seasonality issues-i.e. flu etc). As we all know that certain times of the year sickness does rise. Which impacts on acute and community....

Do you get the feeling someone has sold the emperor some new clothes?

All in all, I think we all need to see a full copy of this report and how much it cost to commission.
The first jobs I think should go is the ones who have commissioned this report as I think they are very surplus to requirements! You probably find that will be £100,000 x 2 which mean 8 less band 3's who need to go!!!

Oh one last thing with all these wonderful supposed savings......
I take it McKinsey will be charging to complete the implementation plan?