Hello. Busy day, so just a couple of quick links here: the Audit Commission and Academy of Medical Royal Colleges have released a guide to money for medics. This comes on the back of Lord Darzi's recent suggestion that budgets could be devloved to clinical teams, and is well worth a read.

Secondly, the latest piece by Nadeem Moghal, the consultant blogger on HSJ drew my attention to an excellent new piece by the inspiring Atul Gawande in the New Yorker (which published Alain Enthoven's op-ed on healthcare reform, mentioned yesterday). Thanks Nadeem.

Gawande's conclusion is stark and depressing. Comparing the patient-centric and evidence-based approach of the Mayo Clinic with the locus of his story, McAllen (where healthcare costs are the US's highest), he ends, "In the sharpest economic downturn that our health system has faced in half a century, many people in medicine don’t see why they should do the hard work of organising themselves in ways that reduce waste and improve quality if it means sacrificing revenue.

"As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future".