I miss things; I really do. (Regular readers are probably aware of this).

This BBC News report on the complexities of the reimbursement for risk-sharing on expensive innovative medicines still took me aback.

How on earth did it seem like a good idea for anyone to leave the reimbursement application process to 152 different commissioning bodies, not to mention hundreds of acute providers?

The Sunday Telegraph's Laura Donnelly knows a non-story from a story - ex-HSJ editor, you know the form.

So it is time to take quite seriously her report on NHS service reductions or removals in progress.

She reports - and will have checked, carefully - that surgery is being restricted, with Hertfordshire PCT rationing hip and knee replacement replacement service, cateract surgery and orthodontics absolutely without the granting of its prior permission on a case-by-case basis.

... but David Forster, policy and strategy director of Yorkshire Ambulance Service, appears to be going for the big time.

The Yorkshire Post reports that Forster told a Facebook discussion, "the NHS has no shame in employing too many who are lazy, unproductive, obstinate, militant, aggressive at every turn and who couldn't secure a job anywhere outside the bloated public sector where mediocrity is too often shielded by weak and unprincipled HR policies".

This BBC News story about the Society and College of Radiographers' recommendation that parents-to-be should not film phonograph scans of their unborn children struck me as stunningly ill-judged.

The defensive tone of the attitude to sonographers who miss defects was a classic 'tell' of defensive medicine. Scanning technology now produced excellent images. Hospitals hit us up for stills at a premium, and we are glad to buy them.

Hiatus today. Back tomorrow.

Have a good weekend.

Advice On The Reconfiguration Of The Upper Gastro-Intestinal Cancer Surgical Service In The South West Peninsula has now been published by the Independent Reconfiguration Panel.

Firstly and rightly, it supports the reconfiguration of services to improve clinical quality and safety for patients. That is unmitigatedly to be welcomed.

It says,

Good morning.

This comes from a train on my way to Reform's health half-day conference (and what a good length for a conference that is).

'Delivering A New Health Agenda' promises us Sophia Christie,
Cynthia Bower, Health Minister Simon Burns, Nico Hencke, Roger Taylor, Stephen Dorrell, Steve Bundred and Alan Maynard of this parish. I'll keep you updated.

Blimey. Nurse tops both own parents.

Beat that, Harold Shipman! 1-0 to the nursing profession.

As usual, the Kissinger-ridiculing genius who is Tom Lehrer has just the tune for this story.

You know my form in the futurology stakes. Caveat emptor.

But anyway, for what it's worth, the three consultations all 'due out this week' as of Tuesday seem unlikely to hit cyberspace this week as planned.

In particular, The Vuvuzela Of Rumour tells me that the 'freeing providers and economic regulation' consultation may limp out on Monday.

The 'commissioning 4 patients' consultation, thought by the BMA to be due by the end of next week, may or may not happen by then.

Is that specific enough for you?

The next consultation is on social care funding, and its website is here. Its terms of reference are here.

Andrew Dilnot is a very smart man indeed, who will make a first-rate chair. Doubtless his first task will be to trawl through all the previous comissionins on social care. He might find a couople of salutory links here.

Tight time-frame, for the end of July ...