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Some questions back to you, Jim:

1) Have you discussed the programme with the TDA or the trusts involved with the programme to ensure you fully understand it prior to pontificating publicly about its merits?

2) Have you visited Virginia Mason or done anything to understand the application of lean techniques in the healthcare context which is the hallmark of its system?

3) Have you ever held a senior position in the NHS (in England or Scotland) which would give you personal insight into what is likely to make changes processes of this kind succeed or fail?

Just curious.