The NHS's economic future isn't what it used to be.

Nor is its organisational future.

Nor indeed is its political future.

Today I had the huge privilege of attending the Bob Sang Open Space, an event held to celebrate and continue the work of the late Professor Bob Sang, whose final article written for this website you may have read.

The day was organised along Open Space principles (AKA the un-conference), and brought together a spectrum of people who did or got patient and public involvement in civic services.

Among the excellent conversations that took place today, there were discussions about the NHS, and its futures - economic, organisational and political.

There was conversation about the fact that only now - as the economic effects of the global banking crisis on public services are going to become clear - only now is the concept of society becoming central to political discourse; be it the Big Society of the Coalition Government or Labour leader Ed Miliband's Good Society (a value-judgment word, 'Good', I think you'll agree).

There were reasons for optimism - they were based on chaos, but they were there. Chaos might crack a dysfunctional culture that has resisted many another attempt to alter its ways.

Policy chaos as reformatory school. You might not choose it. But it's certainly a point of view.

If the future is about greater involvement of people in their healthcare (which it is), people need to understand how significantly that represents huge challenges to how the organisation of healthcare has been run.

In Bob's words, "we're not there yet". But today was another step.