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A low-fat future

There is much that could be written about. Matters of the moment. Big issues. For instance: I'm very worried about global warming

Will Carruthers be able to soup up an NHS that has been spread rather thinly?

There is much that could be written about. Matters of the moment. Big issues. For instance: I'm very worried about global warming. I'm told that if we all turned off our TVs, instead of leaving them on standby, we would reduce our greenhouse gasses.

As I don't have a TV in the greenhouse, there's not much I can do to help. Indeed, I don't have a greenhouse. To play my part, I would have to buy a greenhouse and not put a TV in it. Seems a waste.

In any event, if I buy a greenhouse, to make the glass someone will have had to melt a bucket of sand. That would take a shed load, never mind a greenhouse full, of energy. Presumably, the aluminium frame of the greenhouse would have been smelted - more energy. Then there is the lorry that delivers the greenhouse and let's not forget the lights on in B&Q, all weekend, waiting to sell it to me. The whole thing is a carbon deficit nonsense.

What about Iran? I could write about that. Did you hear that Donald Rumsfeld was recently approached by an Iranian journalist who asked of him: 'Is it true that today only 13 per cent of American youths are able to identify the country of Iran on a map?' Donald Rumsfeld said it was true, however ` just happens that all 13 per cent are American Marines'. Okay, perhaps not.

What about North Korea? That should be interesting enough to engage you for a few paragraphs?

The North Korean Ambassador to the UN bumped into President Bush. Hoping to break the ice with an innocuous comment, the ambassador quickly said: Respectfully, sir, I have a question about what I've seen in America.

In a courteous retort, President Bush answered: If I can help explain things to you, please let me know.

The Korean whispered: My little girl watches this show called `Star Trek' and in it there's Chekov who is a Russian, Scotty who is Scottish, Sulu who is Chinese... but there aren't any North Koreans.

Why aren't there any North Koreans in Star Trek? he asked. President Bush whispered back to the ambassador,'s because Star Trek takes place in the future.

Ominous. However, in North Korea you do get to vote at 17, but there's no one to vote for.

What about Iraq? A friend just back from Iraq told me the most popular joke doing the rounds: a Japanese, American and Iraqi meet a dreadful end in Baghdad, and end up in hell. The Devil takes pity on them and allows them each to phone home. The Japanese places the call and is charged $10,000 for three minutes.


The Devil explains that Japan is a long distance call because it is so far from Hell. The American is charged $12,000 on the same basis. The Iraqi gets on the line and is charged just $2 for a call lasting three hours. Why? protest the others. The Devil explains: Iraq is just a local call.

However, with all that there is to write about, there is only one topic of conversation. Only one issue on our minds. The resignation of the boss of the NHS, Sir Nigel Crisp.

Crisp is toast. Why? The NHS is drowning in a sea of debt. Why? It is skint because, since 1997, four Secretaries of State and about 16 ministers, none of whom, with the exception of Alan Milburn, have had a clue what they are doing, have fiddled, changed, altered and messed with it.

As a result, the NHS has more pilots than easyJet and more targets than a shooting range. Each new idea has cost money.

We have bought a gold card ticket from fundholding GPs and health authorities in 1997, back again to fundholding doctors and health authorities today.

Added to that, everyone has had a pay rise; the nurses about 15 per cent, to stop them all leaving and becoming pole dancers. Consultants have had a pay rise and have been offered as much work as they can cope with: evenings and weekends, moonlighting for private companies, contracting with the NHS for waiting list operations.

The GPs, thanks to a contract that even the Football Association could have negotiated better than the Confederation of NHS Trusts, are now the best paid doctors in the universe.

It is simple. The NHS has had a party and the politicians are wondering how to pay the bill.

Pharma has a problem. The drugs bill has gone through the roof. Glossy new expensive drugs not wanted here, thanks, and by all accounts the economy is set to slow down. The current spending round finishes in 2008 and everyone is predicting `NHS-Lite'. A lead-free NHS for a few years.

Did Crisp deserve to be crunched? No. He has had a soft landing, into the House of Lords, and that tells the story. No longer to be known as Sir Crisp, henceforth he shall be known as Lord Canap?. And life after Crisp? Who next?

Pro tem, and that is all, it's Sir Ian Carruthers. Most managers welcome his appointment. Unlike the intellectual and aloof Crisp, Carruthers likes football, will stand for a drink in the bar and is very matey. He was born in Carlisle, went to local schools, and worked in the city's former Garlands Hospital (now the Carleton Clinic).

He is chief executive of Dorset and Somerset Strategic Health Authority, which is said to be the best performing SHA in the country, and was the first NHS manager working outside the Department of Health to receive a knighthood, in 2003, for services to health.

Let's hope Sir Ian teaches the politicians the difference between them and a manager. Politicians: leap tall buildings in a single bound, are more powerful than a locomotive, are faster than a speeding bullet, walk on water and give policy to God.

On the other hand, managers: lift buildings and walk under them, pick locomotives off the track, catch speeding bullets in their teeth and can freeze water with a single glance. The good ones are God; they perform miracles every day.

The author
Roy Lilley is a (sometimes controversial) healthcare author and broadcaster

2nd September 2008


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