Randeep Ramesh on the NHS

The health secretary has wasted no time in reshaping parts of the health service. To save money, he has indicated that the popular NHS Direct service will be replaced with a cheaper alternative – although there are concerns over the lack of qualified staff to run it.

Andrew Lansley, who has a reputation for being pragmatic rather than ideological, also announced sell-off plans for the state-owned NHS Professionals, a jobs agency that has 50,000 workers on its books and places staff for 2m shifts a year at 77 health trusts.

But the biggest cull, so far, has been that of red tape. Regulators have been scrapped to save £180m in the health sector – consigning the agency that handles public health emergencies to oblivion and splitting up the fertility watchdog. Lansley also carved up the Foods Standards Agency, which had fought and lost a lobbying battle with the food industry over public health.

The real changes will come in the next two years. Under the government's plans, all 10 strategic health authorities and 152 primary care trusts are to be abolished, affecting more than 60,000 managers. It will be an expensive shakeup with costs of the changes pencilled in at £1.7bn. GPs will be handed responsibility for much of the £105bn health budget, removing the need for a layer of bureaucracy. There is more cutting to be done. Before the election none of the parties disagreed with the head of the NHS, Sir David Nicholson, who asked the health service for £20bn of savings by 2014. On taking office, Lansley warned that this "implied something like 3%-3.5%, probably about 3%, efficiency savings each year in the NHS". But he added: "We may need to do more, because we have increases in demand."

Tom Clarke on welfare

Welfare is the single biggest slug of expenditure, and even the bureaucracy that funnels the cash is a mid-table spending department. It costs the Department for Work and Pensions around £8bn a year to distribute £145bn or so in benefits, and to chivvy those who receive them to do things such as find work.

Benefit administration – and the work of jobcentres – is the sort of less-glamorous function that will find itself doubly squeezed because of the partial protection being extended to more eye-catching hospitals and frontline troops. But cuts will hurt the poor, as was seen in the 1990s when penny-pinching and privatisation of housing benefit processing led to routine delays of several months in parts of the country.

Iain Duncan Smith is said to be fighting hard to defend the welfare-to-work element of the budget, and making some traction with his argument that a little expenditure here can reduce the bigger benefits bill. Even so, the work and pensions secretary's baseline in these negotiations is a sharp budget reduction. Casual staff have already been laid off from jobcentres, and I expect others to follow. Watch out for high-profile announcements about the involvement of businesses and charities being used to conceal the reality that there will be fewer resources available to help people find work.

Then there is pensions. The last government made great efforts to persuade poorer pensioners to claim benefits that topup pensions, as well as making these more generous. Pensioner poverty plunged as a result. Expect a big squeeze on this marketing and outreach work, because it is an easy cut to make, and because – by reducing take-up – it will yield bigger savings on the cash paid out. It's easy money, but money snatched from the most vulnerable of all.

Alison Benjamin on the voluntary sector

How can this government achieve its ambitions for a "big society" if the state withdraws support for voluntary organisations? With many grassroots groups across England – from community transport schemes to volunteer centres and children and young people's projects – already reporting that their local authority grants have been axed, that is the question being asked by voluntary sector leaders. Who will advise local residents wanting to take over and run the village library about issues such as VAT, Criminal Records Bureau checks and negotiating the lease, if the local council for voluntary services has closed? In more affluent areas, volunteers may be able to call on the expertise of colleagues and friends, not so in more deprived neighbourhoods.

Around a third of the voluntary sector's income, some £12.8bn, is from state funding in the form of grants and contracts, and more than £3bn a year is estimated to be at risk from cuts. Cabinet Office minister Francis Maude has suggested that voluntary and community groups can expect a bigger share of public funds following public spending cuts. Any gains are likely to be made by larger charities delivering public services through contracts, while small, community groups that rely on threatened council grants are unlikely to reap such benefits.

In London alone, a £26.4m grants scheme that funds 400 organisations is at risk if London Councils give the money back to individual councils to spend as they choose. With no obligation to spend it on voluntary organisations, councils are likely to withhold funds. But expect the voluntary sector to argue strongly, and perhaps with some success, that the speed and scale of spending cuts is damaging the foundations of big society, and that government departments must therefore be mindful of the need to strengthen civil society and look again at the impact of spending decisions on the sector.

Patrick Butler on children's services

Making cuts to services is hard at the best of times: it looks particularly tricky to be trying to make savings in the overheating, post-Baby Peter economy of children's social care, where councils are struggling with dramatically rising numbers of child protection referrals, more kids on the protection register and hundreds more youngsters being taken into care.

Schools, children's social care, family support and youth services typically account for around 45% of a council's total budget. The schools bit is protected, and many nervous councils are looking to effectively ringfence – and in some cases increase – spending on child protection.

The effect of that, however, will be to tighten the financial screw on the remaining "non-core" children's services: that could mean cuts of up to 30% in early intervention projects aimed at tackling problems in high-risk families before they spiral out of control and require the input of expensive safeguarding services.

Matt Dunkley, vice-president of the Association of Directors of Children's Services, warns crude cuts to early intervention will result in more referrals to child protection services further down the line. The association's submission to the comprehensive spending review will emphasise the wisdom of maintaining meaningful investment in prevention.

Dunkley uses the analogy of "a fence at the top of the cliff [prevention] and an ambulance at the bottom [child protection]". Take away the fence, he says, and you end up spending more money on ambulances at the bottom.

Councils have to think "radically and forensically" about how they reconfigure child protection services, he says. That means removing bureaucracy, and working more imaginatively with safeguarding colleagues in the police, schools and the NHS. It also means finding ways to retreat from the current, unsustainable risk-averse approach to child protection. That could be the hardest bit of all.

David Brindle on social care

As the single biggest component of local authority budgets, adult social care is braced to take a big hit. Just how big is unclear, but departmental directors are working on back-of-the-envelope figures of as much as 40% over three years.

John Jackson, director in Oxfordshire and spokesman on resources for the Association of Directors of Adult Social Services, says you get to 40% by assuming a 25% cut across government and adding the rising costs of the ageing population, about 4% a year in real terms.

Like many other councils, Oxfordshire is embarking on a local consultation, asking people where cuts should fall. On a 40% basis, the target would be taking £80m out of a £200m pot, roughly half of which goes on older people's services and half on support for younger adults.

Some councils, including Warwickshire and Lincolnshire, are already looking at raising means-tested charges for services. Others, such as Derbyshire, intend to raise the threshold for service eligibility – although three in four councils already restrict eligibility to people assessed as in "substantial" or "critical" need.

Jackson thinks the potential of such measures is limited. "There are question marks over whether you can make significant savings by going to 'critical'," he says. "The real opportunities, in my view, lie in prevention of need for services."

Andrew Cozens, strategic adviser to Local Government Improvement and Development, agrees that councils will focus less on providing services and more on supporting people to make their own arrangements. "The idea that 'you should always get something' is being called into question," he says.

What could soften the cuts blow would be the transfer of NHS funds to plug some of the looming spending gaps. While this has been hinted at, social care leaders are not holding their breath.

Rachel Williams on youth services

Young people seem to be bearing the brunt of the government's public spending cuts. George Osborne's scrapping of the Future Jobs Fund, which supported the creation of jobs for the young long-term unemployed, means that 90,000 work opportunities have been lost, according to Labour. The Young Person's Guarantee, which promises a job or training to every 18- to 24-year-old out of work for six months or more, is also being ditched. And many Connexions services, which offer those aged 13 to 19 careers advice and support with access to learning, expect to see their budget from the Department for Education (DfE) slashed by half.

The future of the so-called "September guarantee" of a sixth form, college or training place for every school leaver, is uncertain. Labour had pledged to extend it for another three years, but the coalition has only confirmed that it remains in place this year. And government-funded pilot schemes, such as the activity agreement, that were successfully engaging with the most vulnerable and hard to reach young people, so-called Neets – not in education, employment or training – are being ended early. In eight areas of the UK, 16- and 17-year-olds facing tough circumstances such as mental health issues, teenage pregnancy, homelessness and substance misuse were given learning and training opportunities, plus one-on-one support from a key worker. Managers at the West Yorkshire pilot, who had expected the programme to be rolled out nationally, say 60% of the 3,600 young people they have helped have moved into education and training. Another DfE pilot scheme being axed is Entry to Learning, which was aimed at raising Neets' self-esteem and confidence.

Charities and voluntary organisations providing activities for disadvantaged young people have also lost their funding. The last round of grants to the youth sector development fund, for example, has been cancelled.

Peter Hetherington on housing

Is housing becoming an increasingly devalued political currency? The coalition would argue, in varying degrees of enthusiasm, that its reform of the planning system should eventually lead to more homes being built. But the omens are not good. Builders, and housing associations, are despairing over the hasty decision to scrap housing targets alongside a regional planning regime. What to build, and where? No one really knows any longer.

The Home Builders' Federation, representing the big house-builders, has calculated that almost 60 local councils have either delayed housing plans, pending clarification of the reforms from the Department of Communities and Local Government (DCLG), or are refusing to determine house-building applications and are even removing allocated sites from previously adopted plans.

The National Housing Federation, representing not-for-profit housing associations, reckons that plans for 85,000 new homes have been dropped.

Cuts of £450m at the government's Homes and Communities Agency (HCA) – equal, some have calculated, to 6,000 homes – foreshadows, perhaps, a 33% budget reduction over the next few years. The federation says this could see more than 200,000 jobs lost or not created, 350,000 people added to already record housing waiting lists, and a loss of 142,000 planned homes by 2020.

The HCA itself is likely to survive a cull of quangos – although it will emerge in a different form, "smaller and more strategic". DCLG ministers are placing some faith in a "new homes bonus", a carrot for councils to approve plans for new homes with a promise of a central government pot to match increases in council tax gained from new developments. The idea is that this will turn nimbys into yinbys (yes, in my back yard) by helping to fund new community facilities. The department says it will publish a consultation paper before the forthcoming spending review.

Alan Travis on criminal justice

The Ministry of Justice has already agreed to Treasury cuts. Last month its director general of finance informed senior civil servants it planned to make a £2bn cut in its £9bn annual budget. Unions warned that 15,000 jobs are at risk, and prisons would have to close and courts be brought to a standstill. The Crown Prosecution Service has warned that its 25% budget cut will "delay and possibly deny justice". The structure of the National Offender Management Service is being "considered" as part of the department's contribution to the spending review. Under pressure to halt the £4bn prison-building programme, the justice secretary, Ken Clarke, has hinted that he could be in favour of an end to short-term jail sentences. He has set up a review of sentencing policy and new approaches to rehabilitation that could make savings to the £350m prison bill by using cheaper and more effective community punishments. But the main focus of his "rehabilitation revolution" is to involve the voluntary and private sectors in programmes inside and outside prison to stop reoffending and pay them by results.

The police are not exempt from deep spending cuts, and police chiefs warn it will mean having to lose officers. Plans in a police reform white paper to create a reserve army of volunteers prepared to act as community crime-fighters is one answer to budget cuts, another is forcing police recruits to work for free, and Nick Herbert, the police minister, has said he wants to see more special constables.

Mary O'Hara on mental health

Rethink, the charity that focuses on people with severe mental health problems, has been collating data on potential cuts to services since early August. Forty five per cent of respondents to its online survey from across the country have identified cuts to day services, while 40% said they were aware of in-patient beds being put at risk. A quarter (26%) of those who got in touch with the charity said mental health staff jobs were likely to disappear and 16% reported that early intervention services – something widely deemed to be increasingly important – were under threat.

Mind says that instances of severe cuts to local services are emerging, citing the example of Oxfordshire and Buckinghamshire Mental Health Trust, which has announced a consultation that includes proposals that could result in 25% of community mental health jobs being axed. It also said there were indications that police mental health liaison officers could be reduced or disappear altogether.

Mind's chief executive, Paul Farmer, cautioned that cutting mental health provision when demand for assistance was increasing would "cost society far more in the long run".

Paul Jenkins, chief executive of Rethink, said: "It is easier for [health] trusts to make cuts to mental health budgets than it is to cut spending on procedures like heart bypasses or hip replacements. But we can't afford for mental health services to bear the brunt of the axe wielding."

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