So now we know. From the bellowing pomposity at High and Mighty Hall, through the bemused gentlefolk of Meek and Mild Manor to the elitist piety at Pool and Field Palace our glorious NHS has spoken: it’s going to be crap and we’re all in it together.

“The days of institutional virility are over!” bemoan the Beasts of Bedlam to the sound of private finance initiative chickens coming home to roost.

“Only the system can save us!” wail primary care and acute trust alike, as they shut their eyes and embrace the expanding and icy girth of Our Lady of QIPP.

“Told you so!” bleat the self-righteous Cassandras.

Anyone told Monitor? Anyone told the CQC? Anyone told the board? You must be joking. Reorder the following sentence: voting Christmas turkey for.

When the going gets this tough, it’s time for the tough to go with what they know. It’s time to change the vocabulary, to change the acronym, and go back to the future. Like for instance…

Merge the PCTs into something not called a district health authority and performance manage them through something not called a regional office and give the GPs all the money and no accountability through something not called GP fundholding.

Abolish targets and replace them with something called… another word for targets.

Set up an arm’s length body to review arm’s length bodies, with a board appointed by the Appointments Commission after full consultation with all the regulators and reviewed by the Audit Commission.

Writie a document not called The Health of the Nation and set up an arm’s length body not called the Health Education Authority to oversee its implementation. And incentivise GPs using something not called QOF.

Wage war on the bureaucrats and put the doctors in charge. Or maybe the nurses. Or how about giving the radiographers a go? Anyway, let’s send them a form to fill to say how many and by when. Hang on… who fills the form in?