Another answer to the first part of Monitor's ongoing quiz has whizzed its way through cyberspace. Peter Nicholas, who sadly does not say which part of the NHS he is from, but is probably a crossword fan, suggests that 'a step change is a pest'. Ah yes! And while everybody is mulling that one over, we'll move swiftly on to part two: what is an ideological hang-up? The question was posed because that nice Mr Milburn said he didn't have one about the private sector. So this first response had better remain anonymous. 'Ideological hang-ups: these used to be called principles.' Double ouch.
On a lighter note, Thomas Manning, a cancer services project manager in Bristol, writes: 'Dear Monitor. Surely you should know that an ideological hang-up is that little silver hook on the back of the office door where you put your thinking cap.' Dave, another man of whom Monitor knows little, except that he is a colleague of Sue Batten at Edgware Community Hospital, has been thinking along the same lines. Sue says he has told her that an ideological hang-up is a place to hang illogical ideas so they don't get in the way. Developing this, Sue suggests that an ideological hang-up is a 'type of central government wardrobe (like a Cabinet) where ministers and hangers-on get their ideas from'. Indeed, she adds: 'If they carry on, they will have a whole house full of furniture'. Monitor can use Sue's name, incidentally, because she is 'leaving anyway'. But not with any feeling of rancour, evidently.
And finally, thanks go to Sue again for the following joke. Q: How many NHS managers does it take to change a light bulb? A: Two. One to tell the electrician to do it and one to engage a team of management consultants to tell the electrician how to do it more efficiently!