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When Richard Taunt invited me to do this, I should have given him a warning. That my least favourite forms of fiction are science fiction and fantasy. That when it comes to the future, I am right there with the American baseball star Yogi Berra – to whom is often attributed the famous quote: "Never make predictions, especially about the future."​

How do we get our heads around this fact: we have so much knowledge, so much skill, so much progress – but still: so many blind spots, so many obvious insights not acted upon.

The lesson from pre-1865 medicine is that there is no reason to believe health care will always have an overall positive effect on health, no reason to believe that we can construct a system to which we attach lofty ideals and rhetoric, yet is deadly.

Culture is possibly the most important, but also over-used and, at times, meaningless concept deployed by those interested in the organisation and improvement of healthcare. But what is culture? Is there 'good' and 'bad' culture? How can we use our understanding of culture to improve our current healthcare system?

As the NHS has restructured over the years we have taken professional tribes and overlaid them with organisational tribes – commissioner and provider, hospital and community, physical and mental health, health and social care. Sometimes we recognise this, and we learn to speak each other’s dialect – but all too often we simply adopt a new jargon – the “special words used by a profession or group that are difficult for others to understand.” And we hold on to our positional power.

Anastasia Knox argues that the NHS doesn't decide elections, leaders do. While the NHS is often seen as one of the 'hot topics' ahead of elections, the policies of different parties do not determine how most people vote.

Should politics be taken out of the NHS? Can it be?

The NHS is one of the largest and most complex publicly funded health systems in the world and connects research and practice, theorists and managers. How do these communities interact and what can be done to enable more fruitful connections?

​Every year, hundreds of pieces of healthcare guidance are published for the NHS and local authorities. Having worked in national policy-making I've written many pieces of what I thought was useful guidance. Now I’m on the other side as a CCG commissioner, I see how little of it is widely read or has an impact beyond the real enthusiasts.

They say the sequel is never as good as the original. My second Melting Pot Lunch, thankfully turned that on its head. Today’s question was posed by David Haslam (Chair of NICE), with his customary eloquence.