‘It’s difficult to know who to ingratiate yourself with, which policies might survive and which we should backpedal on.’

To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Dead man walking

Dear Don

It must be terrible to be confronted with a terminal diagnosis, to learn that you only have weeks to go; all those arrangements to make, final wishes to fulfil and desperate attempts to find a cure. Who knows what arrangements are now being made at the department, as the corridors of Richmond House echo to the call of ‘dead man walking’ when Patsy walks on by.

Perhaps Gordon and his chums, having played fantasy Cabinet reshuffle for the past 10 years, are now beginning to drool at the prospect of the real thing. Gordon will have looked at the NHS and said: ‘We need a patsy to take the fall for this,’ while his advisers beam and say, ‘I think we might be able to help there, by name and nature!’

A miracle cure looks unlikely as Patsy owns up that the department is as hopeless at hiring doctors as it was at firing PCT and SHA bods in last year’s cull (you remember, the people she said I love you to at the NHS Confederation last year, before she promptly decimated its membership. Baby seals have had it easier in Canada).

It’s all a bit unsettling for the rest of us too. It’s difficult to know who to ingratiate yourself with, which policies might survive and which we should backpedal on. Like a pharaoh will others be laid around the sarcophagus? A couple of pet special advisers? Bill Moyes? Liam Donaldson? Rosie Winterton? All to ease her journey into the afterlife.

She might return to Accenture, the former Andersen Consulting of which she was director of research. That is the Andersen Consulting that used to be a division of accountant Arthur Andersen, Enron’s auditors. I’ve no doubt that Accenture would value her insights as she will be well placed to confirm whether they were right to cut their losses at Connecting for Health last year.

Still, at least the Healthcare Commission has ridden to the rescue with news that 90 per cent of patients are satisfied with their hospital care. Which does then beg the further question - if everyone is so satisfied, what’s all the fuss been about?