Once a records clerk..

I have some experience in Public Sector Finance and what has happened with the NHS's overspend comes as no surprise to me. When you introduce new funding into an organization which has been starved of resources and forced to operate in survival mode, the expenditure gathers momentum and the tide won't subside until all the money's gone plus a bit more.

Large organisations are elastic: they can absorb times of hardship, contracting and retreating but protecting the core functionality. When the siege is lifted and new funding is provided, there will be a bounce-back as the tension is released. Each new expenditure stream introduces the possibility of knock-on expenditure especially when the underlying infrastructure has had to be neglected in order to provide core services, as when the covers are removed the rot will need fixing. Everybody knows this, of course, but it isn't possible (bar the omniscient) to precisely quantify the knock-on effects of any new spending. It's only possible to paper over the cracks caused by over-stretched resources until the pressure is released, and the worse the deprivation has been the more damage will have been caused to the infrastructure.

Forcing the Health Authorities to make redundancies and cancel services to recover the deficit is just not helpful, unless you prefer the word "idiotic": the government should bite the bullet and pay up. If finance directors are underperforming then sack them by all means, but a 1% overspend shouldn't qualify as a disaster even on a budget the size of this one. If anything, the Government's own planners should have anticipated this and allowed for it.

The Government prefers to spend our money on a spanking new fleet of submarines stuffed with nuclear weapons. A deterrent of mass destruction, though who or what they deter isn't clear to me.