I’m not sure I’d agree with some of your points, Tom. I deal, in part, with WAD in the next blog. WAD will never ‘=WAI’ for a number of reasons, some legitimate but others simply a function of using humans to do work. And at the risk of being burned at the stake for being a heretic, I do feel that ‘quality’ is almost a fetish in the NHS. Has anyone ever added up the time spent on ‘quality initiatives’ and the set it against actual lasting improvements? Thanks for your comments. Looking forward to your views on parts 2 and 3.