The government's 2010 Comprehensive Spending Review was anything but comprehensive. The cuts to government spending were modest, and large swathes of state activity were barely touched. Britain will remain a heavily regulated, high-tax, high-spend economy. Instead of totally reviewing the functions of the state and how the government should achieve its objectives, in most areas the spending review was merely a pruning exercise. This monograph advocates a different approach. The authors provide strong evidence that high levels of taxation and public expenditure are hampering economic growth. They also examine the role of the state in key areas and find that current policies are extremely inefficient, imposing high costs but delivering poor results. By combining substantial spending cuts with fundamental reform, outcomes can be improved at the same time as taxes are reduced. Britain can become a dynamic, low-tax economy with welfare systems that no longer penalise work in the way they currently do. At the same time, individuals and families would benefit from high-quality healthcare, education and infrastructure that was focused on consumer interests rather than producer interests.