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"Another fine mess you've got me into" ought to be the headline for LaLa and Cameron's next meeting.

It is depressing beyond words that the obvious logical implications of the basic fact that the NHS is a CASH LIMITED BUDGET has been missed by ALL politicians as they try to convince voters they are REFORMING the NHS.

Choice assumes spare capacity, competition assumes winners and losers but politicians with no moral courage have failed to take on public expectations and challenge lifestyle consequences when the reality was it would have been simpler to ensure performance management of the worst out of the system and get the remainder to meet the STANDARDS of the best.

Now we have PlanB, PlanC and Plan Destruction!