In all healthcare systems, politicians continually strive for the Holy Grail of system improvement. This goal breaks down into three elusive targets: macro-economic expenditure control, equity and efficiency.

The upheaval inherent in the current NHS reforms may undermine expenditure control. This is well evidenced by NHS chief executive Sir David Nicholson continually telling managers that financial balance is an imperative and failure in this domain will lead to their dismissal.

The Proms - the Promenade Concerts - are one of the UK's great cultural institutions. 2010 saw another great season.

PROMs - patient-reported outcome measures - are one of the UK's great cultural innovations. 2010 sees the publications of the first figures for the NHS in England, but results were mixed.

Editor’s note: - Today’s guest editorial is by Daphne Havercroft, who has been campaigning to ensure that the reconfiguration of pathology services in Bristol meets required legal and clinical standards.

Daphne has drawn together a timeline, which shows that the offical narrative regarding events relating to pathology reconfiguration and misdiagnosis in Bristol is contradictory, incomplete and misleading.

This material appeared first on Dr Phil Hammond’s website.

Irwin Brown of the Socialist Health Association looks at GPs’ risks under the proposed new system.

We like our GPs - a lot. So we tell opinion pollster after opinion pollster.

PCTs, by contrast, don’t like GPs: they refer far too many people into expensive secondary care when they could be treated far more cheaply elsewhere. They make appointments hard to get, so people go off to expensive A&E instead. They have got away with working fewer hours, seeing fewer patients, whilst gaining the most financially out of the NHS reforms.

The Charge Of The Light Brigade: cavalry call for strategic sharpening-up and tactical slowdown
GPs seem to have woken up to the fact that Health Secretary Andrew 'The Liberator' Lansley's plans for them to charge the heavy artillery of NHS vested interests could involve their liberation from high levels of trust and popularity they apparently presently enjoy.

Well spotted, people.

The field of battle for this modern-day Charge Of The Light Brigade is not the Crimea.

This letter and all the related documents can be downloaded here.

TO:
All Chief Executives in NHS Trusts in England
All Chief Executives in NHS Foundation Trusts in England
All Chief Executives in Primary Care Trusts in England
All Chief Executives in Strategic Health Authorities in England
CC:
All Chairs of NHS organisations in England
All Chief Executives of Arm’s Length Bodies in England
All Chief Executives of Local Authorities in England

The Sunday Telegraph gets its NHS news priorities right, emphasising the core issue of car parking.

The Coalition Government has, it reports, decided that it will not honour New Labour's more-than-slightly-pointless promise to abolish car parking charges.

Shockwaves of surprise are not expected to resonate far and widely. Many acute trusts are neat;y placed near the centre of busy towns and cities.

You may remember my previous exclusive about the £8 million sale of the Information Centre’s stake in Dr Foster Intelligence to Health Secretary Andrew Lansley on 9 July.

I got this story not through genius, contacts or bribery, but by reading a long annual report. So it goes.

Always read all the way to the back
Like a fool, I still fail to heed my own advice on health policy documents: always read the bit at the back, thoroughly.

Professor Alan Maynard scours the horizon for plausible post-2015 scenarios for the NHS

The Con-Dem coalition government is made of competing factions, driven by different ideologies. As in other governments, political and economic events lead to particular factions getting their hands on policy reform.

The current dominant political faction appears to have adopted some poorly-designed reforms that beg more questions than they answer. They may regret their choices.

When is abolishing NHS Direct not abolishing NHS Direct?

When it's just changing the phone number.

No, it's not very funny, is it? But then Andrew Lansley aspires to be seen more as a liberator than a stand-up comedian.

Lansley has replied to shadow health secretary and Labour leadership contender Andy Burnham, who wrote to Lansley accusing him of yesterday in the Commons misrepresenting Burnham's 2009 statement when Health Secretary.