Hello. Last night's BBC Panorama had got themselves a real-life whistleblowing consultant, Milton Pena of Tameside Hospital. It was fascinating that one spur to Pena's doing the unthinkable - telling the outside world that bad care is going on - was, in his words, "seeing people treated without dignity".

Tameside will be in the shit today. And it would appear, quite deservedly so.

Good day, I hope this finds you well.

You should go first to our latest instalment of The Maynard Doctrine, in which the good Professor fetters out the pearls from a goldmine (he mixes his own metaphors) from a report by the Commons Health Select Committee. It's very good.

Professor Alan Maynard OBE casts a critical eye over the information divulged by the Health Select Committee. Medical unemployment; nurse substitution for GPs; and the delivery of real efficiency increases; and management consultancy spend all come under acerbic review.

Recently, the Select Committee on Health of the House of Commons published its annual report on Public Expenditure. This sets out DH responses to Select Committee written questions, and is a goldmine of extraordinary information.

It would seem that Lord Darzi commissioned three reports from US research organisations - IHI, Joint Commission International and Rand - into the NHS care in early 2008.

You'll find the story here.

What do you reckon, then?

Hello. Today sees the release of a new report from the Primary Care Foundation. (COI declaration - I've previously written up a couple of conferences for one of the Foundation's directors.)

Primary care and emergency departments is a title sure to grab plenty of attention, given the rising tide of A&E attendances and its financial impact on PCTs.

Ten to four SHAs is the latest rumour, chaps. North, Midlands, South-West and South-East, is what they are apparently discussing.

What is the point here? Strategic health authorities have always been mis-named: they are not strategic. They have a degree of authority, vired from The Richmond House, 79 Whitehall (proprietors: Centralising Caped Crusader Sir David Nicholson and Boy Wonder Andy Burnhoid; licensed vendors of visions to gentlemen and their sons), but they are effectively the intermediate arm of the centre.

It’s a good thing David Nicholson really meant it when he told PCTs to “look out to your communities, not up to Whitehall”.

Isn’t it?

You may have seen yesterday that I wrote about the delayed publication of the Co-operation and Competition Panel’s Stage One review of the complaint against NHS Great Weymouth and Waveney, brought by ACEVO and the NHS Partners Network (part of the NHS Confederation).

Oh for fuck's sake.

For.

Fuck's .

Sake.

Here we go again: basic health budget maths
Alright. There are 152 PCTs in England. Their average budget is half a billion pounds each. Yes, it's a generalisation, but it works.

And the above story wants us to get worked up over "the analysis, which used figures from the public board meetings of 100 trusts, shows the health service overspend this year is more than £130 miliion".

Small change on a big budgets

I like Civitas: they’re a pretty intellectually honest think-tank. Not all are.

Today, they’ve published The impact of the NHS market: An overview of the literature - the latest instalment leading up to their main report on markets in the NHS (due out in April).