The purpose of the Labour Party's consultation is to produce a policy for 2009. It is difficult to get people to think so far ahead. Much attention has been given to unpleasant deficit reduction exercises which clearly do not constitute long term policies. Unpleasant though it may be to watch a variety of long term investments which we value sacrificed on the altar of immediate financial balance we need to try to avoid getting sucked into short term debates where we have little influence. We must not be sucked into managerial debates about how things are run. We do not have sufficient expertise to contribute anything useful. In particular the question of whether one way of doing things costs more than another is, in health, almost entirely a question of how various sorts of overheads are allocated. It is not a matter of principle. We do not have to defend the principle of value for money, but we may need to point out how little discussion there is about cheap and effective measures as compared to the endless discussion of the importance of expensive medication which is often not very effective.