Huge comprehensive schools which became dysfunctional over time? Huge new 'Titan' prisons which will almost certainly be hard to manage? Ditto hospitals?

And this week we read of ministerial support for super-surgeries where GPs will be granted the 'NHS franchise' by primary care trusts. There is always an elusive balance to be struck and these are - after all, local PCT decisions, that's the whole point.

But do we never learn? Twenty years ago Mrs White and I abandoned the new local health centre (they could never find our paperwork) and opted for a one-man GP surgery. Who knows, they may accidentally kill us, but at least they will know who they killed.

My scepticism is offset by a recent conversation with Tom Watson, a Labour MP whose constituency in the West Midlands is part of an encouraging pilot of big new premises and (local) tighter standards.

Mr Watson told me GP services which had been poor are now much better. So I will keep an open mind, as I will over Alan Johnson's generous cash settlement (5.5 per cent) for PCTs in 2008-09. Alongside came the new operating framework with its five priorities.

As you may not have read in most newspapers, financial stability has - intriguingly - been replaced by the need to prepare for a flu pandemic.

What are they keeping from us?

Such headlines as there were inevitably went to the threat of fines for hospital trusts which fail to control healthcare-acquired infections or otherwise harm patients.

It is a paradox of localised power since Mrs T's day: we will make you responsible, but punish you if you fail. A bit like handing Basra back to Iraqi control, a good thing but not risk free.

When I caught up with Commons health select committee chair Kevin Barron, he had been caught off guard by the Johnson statement too and has tabled parliamentary questions to find out how many people hospitals do kill.

Apparently, to avoid drug errors in New Zealand they have developed a barcode on prescriptions which ensures that the right patient gets the right dose.

But the Labour MP also poses a wider question about the prospect of budgets being trimmed for misconduct. 'It wasn't possible under the old block grant system. But under payment by results you can find out what the NHS costs and penalise it for not doing better. Is this the way to get over the frustration at not being able to spread best practice? I only pose the question,' asks the ex-deep coal miner.

Since his own industry was shut down in the 1980s for repeatedly failing to adopt best practice he is keener than a former Bennite (Tony, not Hilary) might be to sustain competition and reform in the NHS.

Mr Barron is one of those MPs who belong to the liaison committee on which all the chairs sit and thus was present at what may have been an even more significant health event: Gordon Brown's session in which he finally committed to what I will tactlessly call the Blairite vision for NHS reform.

In a busy day you might have missed it.

Targets were necessary in 1997 to raise standards, the PM explained. 'In the last few years, we have concentrated on a diversity of supply, so we have been opening up supply by competition, by contestability and delivering to people more choice as a result of that, and that will intensify.'

If that is not clear enough, he cited independent treatment and diagnostic centres, as well as personal budgets for social care.

'The next stage is to combine the diversity of supply with a greater attention to the diversity of demand, in other words, services that meet the personal needs of the individual citizen,' Mr B told MPs.

Pressed (by Mr Barron) to guarantee the expanding role of private sector providers, he said it is 'moving up very quickly', but quickly added that it is a matter for local decision making: local vs national.

Locals will make local mistakes, of course. A row over PCT-closed specialist mental beds is bubbling on Radio 4 as I type.