'He is also an inspiration in separating bonuses from performance, exposing incompetent auditors who have overlooked some of his imaginative enterprises, and spending vast sums on management consultants.'

To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Introductions



Dear Don

I hear the welcome drinks for the SHA's new chief executive and chair went well and that your gift of an A to Z of the area was considered very droll. The chair is obviously mortified by the little incident where he mixed up his Pro Plus with his Viagra, and the best that can be said is that he certainly made an impression.

The new chair's credentials are impressive and a testament to Tony Blair's ambitions to expose us to private sector expertise. Looking through the press cuttings, he certainly seems to be an expert on negotiating substantial salaries and perks, and moving on well before his contract runs out with equally generous farewell gifts.

He is also an inspiration in separating bonuses from performance, exposing incompetent auditors who have overlooked some of his imaginative enterprises, and spending vast sums on management consultants. He is an expert in culinary matters (especially free lunches), transport (limousines and Lear jets is are his speciality) and cultural matters (box at Twickenham and a regular Ascot and Henley). The benefits to the NHS are obvious.

In the spirit of enterprise, we have been pondering how to maximise the flexibility of the tariff regime. The DoH seems to have spent more time on the rules than the figures, but a sure-fire cash generator has been found.

The£200 A&E attendance tariff is a money tree waiting to be harvested. We need to drive as many people to A&E as possible to cash in and ensure they don't actually cost us anything.

Therefore we need to attract well people who don't want to see a doctor and will go home as soon as they've registered.

It's simple: we let it be known that we are paying£50 to anyone who attends A&E, provided they don't need healthcare and will sign a waiver. IT are working on an automated booking and discharge system with an adapted cash machine. We'll clear£150 per attendance and our four-hour target results will shoot up.

Who said we didn't have a private sector ethos?