Welcome friends and colleagues, old and new, to this year’s NHS Alliance Annual
Conference. Thank you for coming and thank you for coming in such numbers! What a conference this is going to be! The Government says the frontline of primary care is going to be the future. That means the future is here. You…, you are the future!

It’s really important to learn on focusing attention in areas – on the benefits across whole system as we go, and integration of all government activities on health. That cancer journey (referring to previous presentation) shows how quality is systemic. That’s a very important lesson for us

- the journey, history and context of where we are
- the 6 really big challenges
- the people issues

A full-ish report from the NHS Alliance conference will follow later today. Excerpts and bits can be found at www.twitter.com/HPIAndyCowper

For now:

Healthcare inflation, eh? The HSJ Top People List has grown by 100%. in just a year. That's faster than a journalist's expenses claims ... or an A&E attendance growth.

In truth, it is scant surprise. With this much change around, a limit of 50 was always going to be too much to ask.

So, a few thoughts about the 2010 vintage.

1. Never take lists too seriously

Denial. It's not just a river in Cairo. It runs out, eventually.

I was wondering how long Andrew 'Liberatin' Lansley could carry on pretending that his biggest-ever top-down reorganisation of the NHS was in truth an organic, proctologist-pleasing-bottom-up affair.

If you haven't already read Sally Gainsbury's HSJ interview with health select committee chair (and ex-Health Secretary Stephen Dorrell, you should go and do so now.

It contains a big, unmistakable message.

Some will see it as Dorrell explicitly becoming the health policy Yosser Hughes of the Conservative Party: "gizza job ... I can do that" (though in the interview, he denies the ambition).

The report by Johnathan Brown in today's independent about the Burke and Hare-type exploits of a pathologist associated with Sellafield nuclear power station is a sobering reminder that unacceptable paternalism is by no means confined to the NHS alone.

"When the going gets weird, the weird turn pro" was one of the greatest lines by one of the late twentieth century's most original journalists: Dr Hunter S Thompson.

Rarely has it seemed more aposite than of late, looking at health policy.

You have heard of the theory that life imitates art?

In the realm of public policy, the generally-accepted theory is that life imitates a particularly far-out episode of Yes, Minister.

Irwin Brown of the Socialist Health Association reviews the three cultures of NHS bad practice, and wonders whether the true cultural challenge is a caring deficit.

Reading the transcripts of the Mid-Staffs enquiry, and hearing another series of bad news stories about the NHS in the media, should make us all think hard. We accept the Kings Fund conclusion that the NHS delivers good care for most patients most of the time; that is what the “evidence” tells us.

The Guardian reports that twin children have been killed by a serious untoward incident - it would appear, by a clinical error in rate of medication dosage - at Mid-Staffordshire NHS Foundation Trust.

Oh no. Not again.

A culture of learning from error - and patient safety - seems to be as far away as ever.