To: Don Wise,chief executive

From: Paul Servant, assistant chief executive

Re: Deliberative Consultation

Dear Don,

This is it. No more disingenuity, no more stealth and no more decisions behind closed doors. We are picking up the gauntlet thrown down by David Nicholson, Patricia Hewitt and Simon Stevens and we are going to close maternity and A&E and the public are going to love it.

Patients have been crying out for tough decisions about real choices - and boy are we going to give them what they want. They don’t want nasty, disease-ridden, badly designed, expensive PFI hospitals.

They want a homely nurse and a call centre to cater for their every clinical need from the comfort of their armchair. So we are going to give it to them, and they are going to love it.

How? We have a secret weapon - Deliberative Consultation. I haven’t tried it myself, but Patricia Hewitt says it’s the latest thing in helping managers and doctors understand what patients really want. And I should know about these things: I’ve been to a Dr Foster seminar. These involve three hours in a hotel near the M25 with 150 colleagues, and a couple of young chaps in pointy shoes and funny sideburns who whiz through two videos and a Powerpoint presentation before allowing us to play with their adapted Playstation which allows you to interactively design your local health service.

We got a DVD to take home, which explains everything and comes in a rather snazzy leather-effect case, and all for the bargain cost of£10,019.

Anyway this is how Deliberative Consultation works: we book the local bingo hall for an afternoon and invite a bunch of people with time to spare during the working week - the old, unemployed, homeless and a couple of hoodies for street cred - and we get them to answer some simple questions via a computer voting pad.

Do you like going to hospital? Do you like hospital food? Do you like arrogant consultants? Do you want to be experimented on? Do you want to get MRSA? Do you like the sight of blood? Everyone answers no and bang goes A&E. Job done.