The Treasury was right to focus on National Health Service productivity and on big variations in the cost of treatment, length of stay, and how intensively hospital resources were used, Chris Ham, professor of health services management at Birmingham University, said yesterday.

"But tackling that won't be easy," he warned, commenting on a Treasury presentation, leaked to the Financial Times, which warns that large-scale spending increases cannot continue and that there is a need "to drive higher productivity and efficiency through the system".