Lots of big numbers today.  How will the anticipated budget cuts affect public services, particularly the NHS?  What size will the actual cuts really be, taking account of the spin.  And exactly which services do we think each PCT will be able to stop commissioning? How will that affect the shorter waiting times being achieved for some, though certainly not all, conditions (let’s not allow ourselves to be fooled even though the politicians are). Our highly-rated secondary school has already been busy writing to parents asking for help. Perhaps PCTs might resort to the same tactic?  Why am I not convinced they would be met with the same dedication?

Couldn’t we cut different areas of high fat I hear you cry?  You bet.  Within the overall system there is so much duplication of effort from ivory towers. Hence the sheer weight of policy initiatives. And what about those policing the implementation of those initiatives? There’s no doubt that regulation can be helpful but it really could be managed so much more efficiently than now.  As I’m sure one or two of you might possibly agree.  Particularly when it’s not altogether apparent how much value it adds.  For example, when reviewers of health services this year are more than likely to have an abundance of social, though, bless ‘em, not health, care experience (why don’t you ask?).  And where all the effort of CAA is likely to lead to little more than a bureaucratic, comparatively difficult to use re-invention of UpMyStreet.  Dare I suggest the floodgates are opened and you send answers on a postcard please ….