Yes, I do. Hospitals have more individual control over their budgets than they have ever had before. I can believe the first three categories you mention have an effect, not so much the fourth and fifth, and as for the sixth, that would seem to have very little to do with government - unless you'd like to elaborate on what you think entitlement is in terms of treatment and people. That still won't account for a £55billion increase in spending - unless you believe that there are an extra million managers being paid £55k each, or some other perm/com of that figure.