In 2006, I wrote up a conference report of an event on urgent and emergency care for my friend Rick Stern, now chief executive of NHS Alliance.

The hog-whimperingly unsurprising current demand pressures on A&E made me think it would possibly be useful to reopublish a couple of sections from that report, which appear below.

Integrating primary and secondary care
‘Cracked it?’ - Rick Strang, head of unscheduled care, Hammersmith and Fulham PCT

What are we trying to crack?

Denial is much more than a river running through Cairo. It's an understandable, if unhelpful, response to a fairly grim reality, such as the NHS's is currently.

A very smart friend recently observed that just now, the NHS is working to two planning strategies.

‘Where there is no vision, the people perish: but he that keepeth the law, happy is he.’ – Proverbs 29:18

Simon Stevens is a subtle subversive: a highly effective character type. NHS England’s Five-Year Forward View sets out his broad direction of travel. And it sends a neat, subtextual message to political and system leaders, which they may even at some point notice.

Today's Times leads with a well-briefed story about how senior Tories (no names, obviously) now regard having gone ahead with their NHS reforms.

The piece is unambiguous that the chaotic, hugely disruptive nature of the reforms was understood before the party's MPs supported what became the 2012 Act in vote after vote after vote.

It is, however, silent on why they went ahead with them regardless.

Folly or knavery?

With the delivery of Secretary Of State Jeremy 'Bellflinger' Hunt's conference speech yesterday and Prime Minister 'That Nice Mr' David Cameron's speech today, health policy fans have much to digest.

Let us start with Mr Hunt.

Mascara Kid Andy Burnham's speech to the Labour Party conference today told us little that had not been extensively trailed in his previous speeches and in the party's policy review led by Sir John Oldham.

Well, I have this from a very good source. "£2.5 bn fund (mansion tax, fags) to fund 20,000 nurses, and 8,000 GPs, 5,000 social/community care workers and 3,000 midwives by 2020".

There are problems with going down the workforce number target route. Not because it isn't important to have the right workforce - skill mix and numbers. It is important.

Labour have briefed the BBC's Nick Robinson to trail an announcement of increased NHS spending in Ed Miliband's leader's speech tomorrow - his last as leader before next year's General Election.

Many people don't really understand the NHS, which might be OK if they didn't also try to run it or make policy about it.

So in the interests of helping people understand it a bit better, I'm going to let you in on a secret: the NHS is Russia, basically.

Notoriously big and populous; notoriously hard to govern; and notoriously difficult to conquer.

Obviously, there are a few minor differences. The NHS doesn't drink vodka for breakfast, or have fairly significant oil reserves.

And it's not as if neo-liberal governments are trying to trash the NHS's economy ... oh, hang on ...

Well done, Monitor: nice work.

Yes, you read that right. I typed it out loud, in the real world. I even meant it. Open code bracket; forward-slash irony, close code bracket.