Oops.

After a divisive, and clearly misleading campaign, the UK voted by a small margin to leave the European Union in yesterday's referendum.

This is not good news.

For all Michael Gove's suggested sufficiency of experts, the widely-predicted risks to the UK economy have come true.

"The first day after a death, the new absence
Is always the same; we should be careful of each other,
We should be kind
While there is still time."
Philip Larkin

The killing of Jo Cox MP last week overshadows the political landscape. The personal grief and loss for her family and friends is as evident as it is massive.

Health Policy Insight is nothing if not tirelessly helpful.

With this in mind, readers will benefit from our considerable wealth of experience in attending the NHS Confederation's annual conference, which we have refined into the following etiquette guide for surviving the next few days.

Confed is the Glastonbury for NHS managers, with more deficit one-upsmanship, less trench foot and about the same amount of Dolly Parton.

A note on climate
Manchester is noted for its Mediterranean climate. Sunblock, misting sprays and portable air conditioners are much recommended.

Health economist Professor Alan Maynard wonders, not for the first time, whether we shouldn't perhaps be evaluating some of the latest round of NHS redisorganisation

You will recall that Comrade Lansley’s 2012 Health and Social Care Act redisorganising the structures of the NHS and was described by Comrade Sir David Nicholson as, like the Great Wall of China, being visible from outer space.

Pyrrhic victories all round in the 'junior' doctors' dispute. The deal on offer, recommended by the BMA, looks like some tweaking of pay rates at the margins (it's still cost-neutral overall). It turns out that, in Churchill's dictum, "it is better to jaw-jaw than to war-war".

Oh, and the BMA have 'won' invitations to sit on some committees. As victories go ...

Health economist Professor Alan Maynard wonder, not for the first time, why policymaking and management are still so often uninformed by evidence and evaluation.

The healthcare industry nationally and internationally is vast and expensive. Insurers and governments worldwide spend a lot of effort seeking to control expenditure growth, using rhetoric rather than evidence to improve the efficiency with which healthcare is delivered.

A significant theme is emerging with recent Conservative Secretaries Of State For Health, talking to the BBC about their job in April.

Tom Stoppard's Indian Ink features an entertaining passage where Indian book reviewer Dilip offers American academic Eldon Pike a take on Indian attitudes to beggars:

I have previously borrowed the words of a doctor of divinity, Hunter S Thompson, to describe health policy silliness: "when the going gets weird, the weird turn pro".

The 'junior' doctors' dispute has long since passed the point of mere workaday weirdness.

Health economist Professor Alan Maynard points to the parlous pricing function, cost and value

The admirable Steamship NHS Titanic is being driven into the iceberg territory of fragmentation and privatisation by Admiral The Hunt. After five years of parsimonious annual funding growth of 0.8 per cent, good ship NHS is in dire straits, with rivets pinging from previously robust component parts.