If local surgeries were run like a modern British university you would soon, quite rightly, take your health problems elsewhere. A visit to your local GP would find a forlorn and overworked figure, busily rescheduling their own appointments because patients kept cancelling on them, wondering when your own appointment would be over so they could get back to their real tasks for the day: ranking colleagues for a mock General Practitioner assessment exercise (in advance of a national exercise next year); designing a strategy to increase patient numbers (perhaps by offering out of hours services?); and thinking how to sugar coat the salary savings the local Health Trust have insisted be found by middle management (refusing any increase for another year looks like a good bet). This evening they may (or may not) get to keeping abreast of medical knowledge in their field. The sad thing is that modern British Universities really are run a little like this. We are a long way indeed from the days when Harold Wilson could proudly declare the Open University (our first “university of the air”) open for the provision of quality and affordable education in a modernising democracy…