Monitor’s outgoing executive chair Bill Moyes delivered a typically pugnacious valedictory address.

In recent months he has relentlessly pressurised foundation trusts to prepare for the worst as the recession hits the NHS. Time and again he has pushed them to be more downbeat in preparing their “downside scenarios”.

Yet, when foundation trusts were asked to revise their downside plans as the financial world crumbled, more than half of them came back with one which was more optimistic.

Last week Mr Moyes condemned many of these plans as “absolutely worthless”. That is a very grudging assessment; there is a more positive interpretation.

Any manager who seriously believes things are getting better - as the country teeters on the brink of a lower credit rating, taxes and unemployment climb, demand for services grows, politicians queue up to bash public sector managers as if they caused it all and talk of redundancies fills the air at any health service gathering - has precisely the irrational, non-evidence based optimism needed to get the health service through 2010.

Irrational optimism is the best prescription for NHS managers