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What of those toilet cubicles which allow for both sexes - they have a little notice on the outside saying "either"?

At Ask! restaurant in Durham, where we went on Saturday night with friends, the toilets are more discreet than most.

Senior Management and Director pay in public service seems to have gone up and up recently. Are we really attracting better talent, or is it a game of "who can have the most expensive Chief Exec"? Public Servants used to be motivated to serve the public. The rewards are (still) there - job security, first class training, holidays, hours, gold-plated pension, an honour from the queen. Salaries weren't quite as good as the private sector, but the overall package was probably about the same Attitudes are changing. But which came first?

Letter in Health Service Journal - 17 Sept 2009
"if we're still delivering healthcare the way we do today, by 2022 every able person in the country will be occupied looking after the less able - we have to change" summarised Derek Wanless's Securing our Future Health in 2002. But demand for healthcare will grow, and care means people.

Let's be realistic: this crunch won't last for ever. And when it ends, consumers will need new products. We're going to need innovation in financial services (after all, we can't reuse the failed products of last year and preceding decades). New delivery services (keeping food miles down, recognising more purchasing on the internet, even home delivery services from a trip down the high street so you can go on spending!).

They say another key difference between clinicians and managers is that managers are only interested in what will make money, whereas clinicians are only interested in delivering the highest quality. I don't know if you've studied Lean methodology in any detail? It's a series of techniques for improving the delivery of services and products, and NHS Institute for Innovation and Improvement has released a number of guides of its Productive series, Productive Ward, etc.