There were always doubts about the Chinese wall erected by the architects of the NHS Confederation to divide its health authority and trust arms. The idea that ultimate power could reside in two places simultaneously always seemed unlikely to succeed.

Proposals now being put forward to have a single chair, and for the purchaser and provider councils to meet jointly, are sensible and welcome steps forward (see News in brief, page 8). The days of purchaser-provider apartheid are over, and its advocates have had to change their tune or go.

Good news, too, that the confederation intends to open up policy-making to its members. Few will clamour for a return to the resolutionary politics that once characterised National Association of Health Authorities' conferences, but the process must be more transparent and inclusive.

An organisation which aspires to speak on behalf of all the NHS's constituent parts must do so with a single voice, and what it says must command the full confidence of its members. Only then can it hope to carry weight with those it seeks to influence.