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Editor's blog Friday 28 August 2009: Recessionomics - the cost and price of the shift in the politics of public spending

From the silly season’s decline and fall, we are warming up to the party conference season. On Tuesday, The Indpenedent’s Andrew Grice revealed that Gordon Brown has now accepted that public spending will have to be cut: an announcement of some kind of review should probably be expected for the leader’s speech.

Recessionomics have changed the political lingua franca. Today, The Independent also featured a bit of a non-story about a Tory MEP suggesting a £10 charge for GP visits and missed outpatient appointments.

It is a relief to see that shadow health secretary Andrew Lansley has got his sensible head back on to diss this silly suggestion. As we pointed out following the unfortunately disappointing recent report from the SMF suggesting a £20 charge per GP visit (capped at £100 a year), the revenue raised would very probably be negative, and the damage to both preventative and public health and the image of GPs potnetialy serious.

Lib Dems forward thinking
The more interesting policy suggestion to emerge today comes from Lib Dem leader Nick Clegg, who The Guardian suggests will state that all hospital operations (more or less) should be paid for at the cost achieved by the most efficient providers.

Interestingly, the promised interview has not yet appeared. However, the website for saving suggestions from public sector workers - www.nickclegg.com/intheknow – is up and running.

Clegg acknowledges that his policy cannot be implemented across-the-board overnight: "There has to be suppleness in it … we are not going to be stupid about it." His insight in the asymmetries of power between provider hospital trusts and commissioners, however, seems difficult to refute.

The more so given the Audit Commission’s