Right, enough of this gloom. All together now, we are going to say 'let's stay cheerful for the rest of this column, whatever happens'.

Well, you must admit it was good news during the week that a new type of pharmaco-genetic test could improve lives and save the NHS£30,000 per patient.

And what about the votes of Unison members, the Royal College of Nursing too, 700,000 health workers in all, to accept a three-year 8 per cent pay deal at a time when inflation has been rising and could get worse? That is a grown-up result and must ease fears of an inflationary mentality taking root again.

Not cheerful enough for you? Well, let's ignore the latest decline in NHS dentistry for a moment, the equivalent of 3,674 patients lost each day. How about that£2bn surplus among NHS hospital trusts in the year just ended? That must surely brighten your day.

No? It doesn't do much for the NHS unions, or for the opposition parties at Westminster, though I can't quite see why. Everyone was alarmed and depressed when the system was heavily in deficit, so surely we should be pleased Patricia Hewitt's nasty medicine has turned things round?

I understand the arguments. The Conservative spokesman, Andrew Lansley, protested that wards and hospitals were closed in the Labour years and training budgets slashed, producing a "boom and bust" atmosphere. But whose fault is that, I wonder? It sounds local, not Whitehall, to me.

More intriguing are the heavy hints that trusts, both foundation and standard variety, have squirrelled away surplus cash, for instance by paying tax and national insurance bills in advance, to hide money from a Treasury which may want to take it back.

Admittedly, Alistair Darling is short of a few bob as the economy dips (and is reported to be putting full VAT on the cost of employing agency doctors). Such a claw-back must not be allowed: as NHS finance director David Flory told reporters, the whole point is to give trusts headroom and the confidence to plan. If the Treasury tries it on, NHS managers will just have to whinge loudly, like those under-taxed non-dom millionaires.

The sun is still shining on my keyboard, so I hope you are in good spirits in mid-column. There is a small cloud hovering in the shape of health minister Ben Bradshaw's midweek announcement that when new rules come into force in October seriously failing hospitals could be handed over to private management under franchise.

That upset the health unions, left-wing Labour MPs like John McDonnell and Ian Gibson, and the British Medical Association too. It is a wonderful media word, "could". Only the other day the Daily Beast reported that cocoa could be good for your heart without reporting that the right kind of cocoa is not on the market or that Mars sponsored the research. So when I read that private firms "could" take over a hospital, I think "yeah, right, but they probably won't", especially not as everyone was quick to point out that Secta, a group of consultants, made such a poor fist of its takeover of the Good Hope hospital which serves 450,000 people in Sutton Coldfield and North Birmingham. Its deficit shot up and the hospital was taken over by Heart of England, a foundation trust.

All the same, what is the harm in the option? The usual suspects cry "privatisation", which it is not, not really. It is there to concentrate minds. After all, 30 trusts out of 290 are responsible for almost half the cases of MRSA, more than half the 18-week waits. Local, not Whitehall, again, eh?

And as a general rule any policy opposed by Unison, the Campaign group of MPs and the BMA can't be all bad.

I have left until last the King's Fund's warning against over-reliance on the "big building" model of polyclinics which may emerge from Lord Darzi's review of GP services. I have a lot of time for King's Fund research and it goes without saying His Lordship is the Mother Theresa of UK healthcare.

So a sombre warning about costs, accessibility to centralised services in rural areas, even quality of care, must be good news. And didn't Darzi promise us no one model will be imposed? Good news too, I'd say. Chin up.