To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Do as I say not as I do

Dear Don

I gather your factfinding summer visit to South Africa with Mrs Wise and the children went well. Your thoughts on ambulance response times on safari have given our colleagues down there much food for thought. Nor have we been wasting time in your absence. I have been ploughing through some light summer reading. One particular book, 5,367 Simple Steps to Becoming a Foundation Trust makes it all seem so straightforward.

There are 10 chapters. Chapters one to seven basically require us to achieve PhD-level understanding of international accounting practice. Chapters eight and nine detail how we will establish monitoring systems three times more substantial than required by NASA to launch a rocket and chapter 10 is all about developing the required po-faced, humourless and sanctimonious attitude essential for discussing the benefits of foundation status.

Oh and there’s a half-page appendix on membership, involvement and engagement. I found the word patient mentioned twice. Meanwhile our stationery supplier has acquired a part of the Amazon rainforest the size of Wales to accommodate our application form requirements.

It’s all about standards, performance and assessment. So it was interesting to note that Monitor has joined with other parts of the NHS aristocracy in saying ‘let them eat cake’. Last year the Healthcare Commission said it was more hopeless than the trusts it regulates in responding to complaints, the Department of Health cannot sort out its own turnaround plan and now Monitor is moaning that its millions of bean-counters can’t spin their abacuses fast enough to process more than half a dozen applications every few months. Thank God these people don’t run the NHS. Oh bugger.

So just as we all enter the final straight to eliminate waiting lists and achieve the 18-week holy grail, Monitor, the most perfect of regulators, creates a new waiting list. Perhaps the Healthcare Commission should investigate and require an action plan.