there have been acrosstheboard rationalisations of expenditure in all sectors of the health system and permanent cuts to public sector workers salaries including those of health professionals since in efforts to reduce costs these pressures combined with the fact that private spending is already high figure and unlikely to be able to stretch further create tangible concerns over the adequacy of health system funding especially in the longer term in response the sector has seen a number of evidencebased measures aimed at securing savings and enhancing efficiency box however despite the huge reductions current spending on prescribed and overthecounter medicines makes up over a quarter of all health expenditure and is among the highest in the eu before the crisis high private capacity combined with weak sickness fund bargaining power poor payment procedures the lack of clinical protocolsguidelines and a failure to monitor doctors use of diagnostic tests created an incentive structure conducive to overconsumption and waste