What is the position with beef? Should I be serving it to patients and advising everyone not to eat it, or not? There is much confusing advice about, and I really don't know where to turn. Help.

Ronald, Banbury.

Well this is a poser, isn't it? Of course, under the Tories beef was bad; and directly as a result of the interventions of John Selwyn Gummer force-feeding dairy herds, cows died like flies because they ate too many hamburgers. But now that we have caring ministers for ag & fish and health (separate ministries, mind), things are obviously much better and beef is good again. This is called 'caring about the countryside' and 'listening to farmers'. Nonetheless, a balanced diet is best, although environmental concerns lead to some worries about vegetables and cereal products (flatulence is a major cause of depletion in the ozone layer). This means that things made of vegetables (margarine, quiche etc) or whale blubber (margarine, soap) are probably not a good idea. I suggest mixing beef, dairy products and tofu in your patient menus and advising the community to pay more attention to lemongrass-based salad dressings (for use on their beef, not salads, of course).

What is the affordability test as applied to potential PFI schemes? My trust is about to sign up for a major development project and regional office wants us to do the test.

Where do I start ?

Bob, Penzance

My, there is a lot of rubbish talked about this, but it's really quite simple. First, work out how much you want to spend, then work out which services and in what quantities you need to provide (but of course, you'll have done this already). Then simply divide one into the other. Sometimes you'll find that the cost of the services you want is more than the money you have to pay for them. This is called 'managerial inefficiency and bureaucracy'. If this is the case, just take the percentage of patients treated as day cases or as domiciliary visits and adjust it until the service level matches the available cost. This is known in the trade as a balancing item. Everyone's doing it. You can see how effective it is by the number of highly successful and cost-effective PFI schemes coming in under budget all over the country.