To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: NHS reshuffle

Dear Don

Gosh, what an exciting few weeks. We almost got a new prime minister, but ended up with a new secretary of state instead. It was also the week of the Confed’s annual attempt to boost alcohol sales in deprived towns by bring 2,000 high spending alcoholics to Liverpool. But the poetry of it all was just beautiful - one of their own, getting made up to run the Department of Health. 

This is evidence if ever you needed it of Confed’s strategic thinking. Taking a leaf straight out of the KGB’s bestseller, Espionage for Idiots, they planted a sleeper in the House of Commons who 15 years later reaches the top. It now simply remains for the secret code word to be uttered and management will truly have taken over. Mind you, the situation could be read completely differently. 

This could be the end of NHS management as we know it. We have just celebrated the 25th anniversary of the Griffiths report, which created us and did away with the tripartite leadership of the NHS. And lo and behold, we now have at the Department of Health a pre-Griffiths tripartite leadership of administrator, doctor and nurse.

But it’s not all sweetness and light. The Confed has warned that the NHS may not survive. Which is usually the BMA’s job. The BMA has warned of a “dark and dangerous period” ahead. But rather than a clarion call to save the NHS, which would have joined 3.5 million other mentions on Google, the BMA has gone for a more pedestrian “look after” the NHS campaign - I’m sure they’ll be rioting in the streets around Tavistock Square after that. 

To finish off such a thrilling week we hear the exciting news that Mark Britnell, the man who put the WC into commissioning, is not going to hang around to see it happen. Hmm… Gordon Brown isn’t the only one who knows how to dispatch pretenders then!