I'm really busy today, and haven't time to write much, so would recommend a couple of other things for you to read.

The first is from Professor David Colquhoun's Improbable Science blog, on the subject of queueing theory and ITU beds. It is superb, clearly written and very comprehensible. Best wishes to him for his forthcoming operation.

The second is a re-read: David Nicholson's 'preferred provider' letter, published a mere four weeks after the policyt was announced in Andy Burnham's speech to the Kings Fund.

Is it just me, or does this feel more than usually cobbled together?

The obvious, stated
The letter says, "we will provide guidance to PCTs on the processes we expect them to follow, which includes engaging with NHS organisations and their staff and trade union representatives, coupled with strengthened assurance processes". Yet the NHS could not have done otherwise.

It states that the policy does not affect the 'right to request' to form a social enterprise.

The letter goes on, "For new or substantially redesigned services, PCTs would be expected to engage fully with the existing provider(s) and staff at an early stage, as well as other potential providers, enabling them to contribute to service specifications. Only after this would a decision on whether or not to openly tender take place. When competition is used it should be transparent, equal, fair and proportionate to deliver the best care to meet the needs of the local population." Again, there is nothing new here.

The scenarios, principles and requirements are nothing other than would be needed to protect your decision against the accusation of undue process (or perhaps judicial review, if a trades union came in with the money).

The need to give six months' notice of intention to discontinue commissioning or providing a service is thought to date back to the internal market.