The cultural logic is appropriate that in an NHS broadly run along Soviet (if not Stalinist) lines of centralised command-and control, you would have czars somewhere in the mix as a nod to the imperial past.

The Department of Health has a plethora of czars in its crown. Prominent among them is its cancer czar Professor Mike Richards, who was given the hospital pass of doing a report to justify increased spending on expensive cancer drugs. Which he did.

Thank you to Dave West of Health Service Journal for drawing attention on Twitter to Earl Howe's answers to questions in the Lords on the proposed changes to NICE.

At the top of the debate, you find that Baroness Sherlock asked Earl Howe, "To ask Her Majesty's Government which groups were consulted prior to the announcement that the National Institute for Health and Clinical Excellence was to lose the power to decide that some drugs may not be supplied by the National Health Service".

The email below, sent by NICE chief executive Sir Andrew Dillon to NICE committee members, reveals clearly that the government's pronouncements and particular emphasis on changes to their role took NICE themselves by surprise.

What a vote of confidence in NICE by the Government.

EMAIL TEXT BEGINS:
Dear Committee Member,

Today was an interesting day in parliament. In the morning, the increasingly promising health select committee took its second evidence session on commissioning. In the afternoon, the new opposition health team had their first go at health questions.

What, then, did we learn?

From the commissioning evidence session, Dr Richard Vautrey of the BMA re-emphasised that the bulk of future commissioning will be done by "lay managers", criticising the poverty of central efforts to create clear messages for good managers in retention.

Profesoor Alan Maynard wonders what the changes to NICE’s remit mean for rationing.

Just what do the Con-‘em Coalition plan to do with NICE and the market for pharmaceuticals?

Firstly we have Cameron’s “Cancer Drugs Fund”. This was a bag of NHS swag used to buy votes in the election by pleasing both cancer patient groups and the merchants of inefficient and highly expensive cancer drugs to which NICE had said no.

You've probably noticed that we've been keeping an eye on NICE issues: so have others.

This excellent blog post from 'Gimpy' elucidates the relationship between Big Pharma and the funding of the Rarer Cancers Foundation.

You may have seen that we picked up on the news about public sector outsourcing giant Serco's fascinating supplier engagement strategy yesterday.

Serco appear to have changed their mind.

My grandmother was a world-class fatalist. One of her many endearing habits of form was to stare out of the window on a darkening evening, and intone, "ah, the nights are drawing in".

Celtic melancholy to the power of ten ... whose impact was only slightly blunted by her tendency to start doing this almost immediately after the midsummer solstice. It doesn't really work in early July.

And now it is November, and the nights really are drawing in.

Professor Terry Young, Chair of Healthcare Systems of the School of Information Systems, Computing and Mathematics, Brunel University, outlines the new approach from the Cumberland Initiative to using modeling techniques to deliver massive improvement in healthcare.

What is the best possible outcome for the NHS in its struggles? Twenty per cent savings? Twenty per cent more care?

You know the mythology of the inefficient public sector and the efficient private sector? Of course you do. As with all mythology, it starts with a kind of truth, in the form of the clarity of profit and the simple power structure of the shareholder interest.

And what brilliantly innovative methods is one of the biggest private sector providers of outsourced public sector work using to drive efficiency?