What is a glass ceiling ? I seem to remember someone else asking you this some time ago but I've forgotten the answer.

'Susan', Manchester

What a forgetful little girlie you are, to be sure! Glass ceilings were something invented by Mrs Thatcher to stop young ladies rising through the NHS to challenge her position. Clearly, they had absolutely no effect as women are now very well represented in the NHS.

You only have to think of how many nurses, say, or outpatient clerks or orthopaedic surgeons are women to understand this. However, it is one of the wonders of our unwritten constitution that when things lose their usefulness we do not automatically get rid of them. Oh no! We wait until they become useful for a different reason. This is what's currently happening to CHCs and in the past It is happened to private practice.

You might remember how PP was once the mechanism whereby consultants could earn enough money to play golf a lot, whereas now, of course, It is a jolly good way for trusts to make some money and clear waiting lists. As for glass ceilings, they are becoming very useful to enable NHS managers to spot the next policy initiative coming.

What do you make of the new national strategic framework for elderly people? How should I go about implementing it when the local authority hasn't got enough cash to pay for community care for all the old dears filling up my acute wards?

'Eutha', Dover

Old people are obviously a good thing. The trick is to keep them happy and occupied so they do not get involved in drug trafficking and so on. They are very clever at all sorts of things: crocheting tea-cosies for example, even when they are quite decrepit. So do not write them off; they want to work, you know, and are tired of living off state handouts. Of course, the important thing is to make sure they've all registered for a postal vote so that we can demonstrate to American tourists that our democracy is alive and well and more than capable of seeing off the foot and mouth thingy. But when Mr Blair gets returned with a thumping majority that will demonstrate that everything's all right after all, and your elderly residents will be happier than ever.