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I know you’re in the middle of something – thanks for even stopping by – but could I borrow you for two quick thought experiments? Only be a minute.

Artificial Intelligence is opening up new frontiers, whether in health care, business or (only slightly alarmingly) warfare, promising a new generation of ethical conundrums. The quandaries caused by driverless cars may require grappling with sooner than most. ​

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.

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

​Every year, hundreds of pieces of health and healthcare guidance are published for NHS and local authorities. Having worked for most of my career 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.

Annual funding for the NHS is falling ever further behind increases in activity costs. The government’s promise in 2015 of an additional “£8bn” assumed heroic savings of £22bn over a five year Parliament, which health policy experts think unattainable. The NHS now has the biggest deficit in its history.

The NHS is no stranger to five or ten year plans. Today’s publication of the 'Five Year Forward View' takes its place in a lineage that includes 2009’s 'NHS 2010-2015: from good to great' and 2000’s 'NHS Plan', among a library full of other titles with similar echoes of communist tractor production.