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Adrian Fawcett's contribution is one of the most disappointing pieces of writing about the future of healthcare I've seen in a long time. And belivev me, there have been plenty of fairly lacklustre pieces around to ofeer a benchmark.

We're constatntly being told that the private sector could hold the key to innovation and new patterns of delivery in healthcare, and what does Fawcett offer ? Just the same old same old - so let's pick just s few:
- a future in which he is apparently still fixatred by acute hospital provision, rather than looking at the fundamental community-focused service redesign that's really needed
- a similar apparant fixation with the opportunities offered by London (and presumably other bog cities)
- still continuing to virtue the opportunities offered by excess capacity, where it's clear that there aren't the resources to sustain that. We're loiving in an era of flat cash. Has he not realised ?
- he talks about 'reconfiguring' by which he clearly means the market. What's needed is fundamental service redesign. Where are his ideas ?
- the issue around funding is right, but a complete red herring at this point in time

Quite frankly I'm profoundly unimpressed. If this acute hospital metro-centric stuff is the best Adrian Fawcett can come up with, he needs to go back to basics and think again. I'm working with a commissioning consortia, and this is frankly lacklustre. We need better, we need innovative, This isn't it.