David Fraser got involved with Health Rendezvous - chairing this year's conference - because of an interest in French healthcare. Though now chief executive of Dumfries and Galloway primary care trust, he once worked in the French public healthcare system.

Health Rendezvous has no formal members. Mr Fraser wrote to all NHS chief executives to ask them to support the conference, and he believes the biennial meetings enable delegates to get a perspective on a system which, though different, is not unlike their own.

When he worked briefly in France 20 years ago, general management had already been introduced and the system seemed much more dynamic than the UK's. 'Now it appears more bureaucratic than our system, although there is a more stable environment and more resources available for healthcare, ' he says.

Managers who work in public hospitals in France are moved to new jobs every three to five years. They are recruited young and stay in the system until they are 65 - there are no moves in and out of the private sector.

They get a free house and car with the job and there is job security, although salaries are considerably lower than in the UK.

'But will this system be able to continue for the next 40 years?' asks Mr Fraser. 'It really doesn't look like it will.'