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Why is there always an assumption, often stated but sometimes implied, that private sector leadership and management are somehow superior to those in the public sector? It's a myth wholly unsupported by any convincing evidence. The fact is that life in the private sector is infinitely simpler compared with the public sector which has to juggle multiple and competing objectives and is not driven by profit and shareholder value. Outcomes are more complex and often conflicting. It would make for a more sophisticated, useful and nuanced discussion about what the NHS needs by way of leadership style and skills if comparisons with Tesco, McKinsey, Serco et al were abandoned. They have less to offer than is often suggested. The way would then be clear to have an informed discussion about the nature of the challenges and how they can best be met instead of a discussion too often driven by faith-based prejudices and ideology. Horses for courses springs to mind and horses from the private sector invariably fall at the first hurdle when confronted by the public sector. The NHS can testify to that. This is not to argue in favour of the 'usual suspects' with one exception perhaps. I for one regret that Bruce Keogh is not putting himself forward. He ticks a lot of the boxes in terms of the type of leader Malcolm Grant says he is seeking.