1 The New NHS: modern, dependable. The Stationery Office, 1997.

2 Ibid.

3 Personal conversation with Geoff Meads, health management group, City University.

4 The New NHS: modern, dependable. The Stationery Office, 1997.

5 Ibid.

6 EL(97)39. NHS priorities and planning guidance, 1998-99.

Mike Pollard is chief executive of James Paget Healthcare trust.