First, it was targets. I definitely remember the Conservatives promising to abolish targets.

Next was added a variety of adjectives: "process" targets, or "clinically unjustified" targets.

But they were definitely going to abolish targets.

(Of course, they're not really being abolished; just not centrally performance-managed. The NHS Constitution, which forces NHS commissioners to "have regard to" targets could of course scupper this - especially in a country which uses case law to set legal precedent. So could Monitor, if they so chose).

But even if we accept that they are jolly well going to do something about those beastly targets, chaps, perhaps they could have come up with something just slightly less shit than changing the name from 'target' to 'goal'.

Now allegedly, there is a good reason why Wayne Rooney proved goal-shy for The England. It will apparently appear in a tabloid newspaper near you soon.

Now I love NICE considerably more than the next man in the street. (Nobody has ever bettered what Sid Vicious said about the man in the street, by the way.)

And these new evidence standards are what NICE has always been doing, and always good at doing.

That is not the point. The point is that when you launch them at the BMA conference, with the Health Secretary there, you are sending a clear signal of their priority to the Powers That Be In Power.

Targets are dead. Long live goals. AKA targets.

Plus ca change ...