I felt the hand of bureaucracy come down on me when I opened a letter from David Nicholson. It had a catchy title " Service Improvement:Quality Assurance of Major Changes to Service Provision".(sic) If Labour were in Opposition they would doubtless have dubbed it the letter about the cuts.??

It told me that Sir Ian Carruthers has completed his review of all the main changes being thrown at the NHS. In a four page letter his thoughts were summarised, but for greater precision I was also sent a copy of his report.

??Sir Ian allowed himself a veiled attack upon the way these changes have been presented by the NHS so far. In one of his clearer and more interesting paragraphs he says:

"It is important to consider carefully the language used in describing the kind of change that this review has considered. Reconfiguration conjures up a whole host of images, not all of them positive, and has become a euphemism for closures and downgrading of hospitals. This is an entirely wrong impression of the schemes looked at over the past few months"

Well, that’s a relief to know that. All those closures of trauma units are not really closures, and have been wrongly called reconfigurations. Get the language right, and we will all be glad to have travel so much further to find trauma treatment.

It was not until I reached page 8 of Sir Ian’s Report that I found a conclusion I strongly agreed with. Sir Ian has decided that in future NHS documents sent out to the public should "be clear, concise and written in plain english". Perhaps?? David Nicholson, the Chief Executive, does not agree with that. In his four page letter about a series of abtractions he says:

" However we can and must do better in how we make these decisions, from establishing the evidence base and case for change, through to having proper implementation plans with clear and robust realisation timetables.. etc etc"

Mr Nicholson struggles with reconfigurations. He cannot bring himself to drop the word which Sir Ian had concluded should be banned. The CEO says:

" This review demonstrates that the majority of reconfigurations are about providing safer care and service improvement, and that finances are not the prime driver for service change" Does this mean that in a minority of cases reconfigurations are about less safe care and service reduction? Surely not. Does it mean that in a minority of cases money is the prime mover? How many cases are in this minority? Could we have some clarity, some plain english, to tell us what is meant?

The concluding words of the CEO’s letter appear to??have been taken from the Home Secretary’s song book. We are told " Sir Ian’s work provides us with a real opportunity to raise the bar and learn from the best in the NHS, so that the NHS can continue to evolve and adapt to the needs of all patients and be fit for purpose in the 21st century"

Let’s hope he meant it is still fit for purpose today before the reconfigurations- the Home Secretary struggled from the moment he told us the Home Office wasn’t

??

This morning on the Today programme there was an item explaining that the attitude of the US administration had set back the work to tackle climate change by daring to voice scepticism about the science.

The BBC should do its homework and they would discover that US carbon emissions have been rising more slowly than European ones. They should realise that some important European countries will not hit their Kyoto targets. Which is worse -?? not signing Kyoto, or signing it and then failing to implement it?

They should discover that the US has progressively tightened its regulations concerning pollution from motor vehicles, and has pioneered some of the renewable technologies that can help. This regualtory approach to the problem happened on President Bush’s watch. How do they explain that?

Scientific advance requires continuing scepticism about all current theories. The BBC should study the actions of governments and people as much as listen to their words. As Al Gore has shown, it is one thing to say all this matters, but it is quite another to live a life that matches the challenge. Al Gore has travelled so many air miles peddling his film, and we now learn that his own home is a??power guzzler. No mention of that on this BBC item on climate change.

Like the present government I hate slavery.?? I have no objection to our country saying we are??sorry that??British slave traders made money out of this barbaric trade more than 200 years ago. If we say this we should also say we are proud of those who campaigned against the trade, and through public protest and Parliamentary action achieved its abolition in the UK. Few of us know whether our ancestors were the good guys or the bad guys in this passionate argument of 200 years ago.

I do wonder how far, however, we should extend this judgement of the past by the standards of the present.

When. for example, are the French going to apologise for all the British people they killed in the Norman invasion, and in the Napoleonic wars when once again they wanted to violate our shores?

When are the Spanish going to apologise for the fear and suffering caused by the Spanish Armada?

Some people in the UK always want to see the UK as the wrongdoer. Sometimes our country was the victim of war and barbarism, sometimes it was the crusader for the right cause.

On many occasions our country has stood up for the freedom and right to self determination of the smaller nations of Europe.??That is something we should celebrate.