The Kings Fund's policy events are usually must-attends; irritatingly, a sick nanny prevented me being at their breakfast session this morning.

Robert Creighton, a very able and very experienced PCT chief executive, to whose day job running NHS Ealing has been added NHS Hounslow and NHS Hillingdon, took the career-limiting move of telling the truth at this morning's event.

Pulse reports him as saying of the current reforms that the NHS is "at risk of blowing it. This could be a bloody awful train crash. It could collapse. All of us are looking inwards.

"This must be (done) working together, but we are at risk of blowing it. Sometimes I feel I’m only doing what I’m doing because of a sense of public duty. In two years time, I will probably be out of a job. The Government is saying that everything I have done for the past eight years has been bad or should be destroyed. Where’s the sense of that?".

He is of course quite right - though it is not a surprise. NHS CE Sir David Nicholson did not demur strongly when Dr Sarah Woolaston MP stated that some PCTs were "in meltdown ... this is happening in an uncontrolled manner" at last week's health select committee meeting.

An outbreak of contagious honesty
One highly predictable result of the White Paper's telling 45% of NHS management that their jobs are on the way out is that an outbreak of highly contagious, very public honesty will follow. This is not usual in NHS management culture.

Nor is Creighton a career suicide type. This is going to have more impact as a result.

Well done for speaking up, Robert.