To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Manager in a manger

Dear Don

We have no fear that everything will run like clockwork while you take on another gruelling winter tour, this time a study of Kenya's healthcare system. Your report on primary care systems on safari will be a lesson for us all. Naturally, we will keep the trust hotline open in your absence as surely this time the New Year's honours list will recognise your magnificence.

The trust carol concert is upon us once more. We have adapted the chaplain's carol book to make it more NHS friendly. An example for you below is The 12 Days of Christmas. The last verse is as follows:

On the twelfth day of Christmas

Alan Johnson sent to me:

Twelve surpluses for topslicing;

Eleven PFI builders profiting;

Ten SHAs a role for themselves


Nine smokers still puffing;

Eight grannies a-dumping;

Seven GPs for the whole country

over Christmas and New Year opening;

Six obese health advice ignoring;

World Class Comm-iss-ion-inggggg;

Four Monitor nerds;

Three did not attends;

Two polyclinics renaming;

And the second coming from Lord Darzi.

And another old favourite:

We wish you world class

commissioning (repeat twice more)

But it's nowhere near.

Good tidings we bring

From Britnell the King

We wish you world class


Maybe one day next year?

And lastly:

Jingle bells

The tariff smells

Why won't it go away?

Oh what fun

It is to decide

To implement it anyway.