Monitor wishes to join the grovelling rush to congratulate Sir Alan Langlands on his reappointment as NHS chief executive for a further four-year term. Jolly well done, sir. It obviously scotches all that scurrilous gossip about Big Al getting ready to up sticks and quit - so what can account for his devil-may-care conference-circuit advice to managers to ignore all those health service circulars? Let's see, now. . . should Dobbo take it into his mind to get rid of him, it's four times £115,000, plus pension contributions, plus a few other bits and pieces. Shall we say a £750,000 pay off? Of course, this is pure speculation, but if Big Al gets in touch, with the correct termination figure, Monitor will be only too happy to pass it on.

Sticking with the giants of the management world, one of the little tasks carried out by incoming IHSM president John Brunt is chairing the North West waiting list task force. Which may be just as well, for he is shortly going into hospital to have a hip operation. This, he says, is the result of 'spending much of my adult life seriously damaging joints and bones through involvement in rugby, cricket, fell-running and squash'. Clearly a personal incentive to drive down waiting lists in the region. He promises that in future he will minimise the cost to the NHS by restricting his exploits to swimming, squash and walking Morgan, his border collie.

Meanwhile there is news of a ground-breaking management initiative from the finance department of Wolverhampton Health Care trust, which, following a brainstorming session back in February and three months of cogitation and analysis, has produced some really stretching targets. Monitor's favourite is: 'All staff will be paid on time.' No mention of whether they'll get the right amount.

And finally, Monitor has to report that the worst is not yet over for the Kosovan refugees. As if they haven't suffered enough, news arrives from an organisation calling itself FrontLine Homoeopathy that teams of complementary therapists are on standby to fly into the Balkan refugee camps to offer treatment. Now what you really need when you've been shot at, forced from your home and ejected from your own country to live in a tent city is a nice bit of arnica or a sniff of essential oils.