Thank you for making a mess of our business. Here's three million quid

In corporations of a certain size, the more of a dog's dinner you make, the more they like you for it

Been away, between columns, in search of a little sun. You can work out how many days that is yourself. Not many. Funny, though, how short a time you need to be gone before everything looks different on your return. We were a healthy country when I left; now everyone is obese, asthmatic, and dying of other people's smoking habits. We had children coming out of our ears last week; now there are not enough of us (enough of us who are indigenous, that is), and the infertile are suddenly our first concern.

As for the children we do have, they can be vaccinated after all, or at least the reason why they couldn't is no longer considered to be a reason, but we are also burning too many of them in their beds, I have just heard someone say on radio, and so we must have more smoke detectors. That universal infertility would solve the problem of infant mortality, by whatever causes, at a stroke, nobody but me appears to have realised.

But then I've been away.

At the other end of our sad little sojourn between being lucky to be born and hanging around too long waiting to die, things are no less calamitous. The old, they say, are falling over and breaking with more frequency than the country can afford, so we must encourage them into not too strenuous tea dances and keep-fit classes - not too strenuous, presumably, else they'll fall over and break again.

Myself, I think forcing activities of this sort on people still of an age to be accused by Naomi Wolf of molestation-with-aggravated-hindsight is so demoralising that it will do more damage than it prevents; but nobody cares about heartbreak, only broken limbs. A National Health priority. A profit-and-loss man's priority, at any rate. And guess what? It's a profit-and-loss man who's been scrutinising the National Health Service and scaring us half to death into the bargain.

How long did I say I've been out of the country? Six days going on five years? Beats me, but I'm sure that when I left last week Derek Wanless was being offered a golden parachute of £3m by way of saying thank you for cocking up NatWest - that was my understanding, at least - and now here he is presenting his second report on the state of our health services.

Well, good luck to a man who can achieve so much so soon. But I do wonder about the appropriateness of getting the one-time chief executive of NatWest to comment on the nation's health when the NatWest has contributed so significantly to its decline.

One speaks, of course, as one finds; NatWest is my bank and not everybody's, and not everybody who banks at NatWest will have burst a blood vessel every time they try to pay in a cheque, cash a cheque, make an enquiry, or otherwise avail themselves of the bank's services, but most of those who do, have. You want to see people in physical distress, unable to breathe, unable to stand, suicidal, homicidal, without the wherewithal to co-ordinate their actions to their will, then forget McDonald's or any other of our gaudy obese-burger bars, forget the choking, smoke-filled dens of Soho, or the winter stumbling grounds outside old people's homes, forget even the corridors of our hospitals where the too-fat-to-move lie on unattended trolleys waiting to be made fertile for free - go stand instead outside any branch of NatWest, where the queue coils haplessly, Wanlessly, into the blank street, because someone, somewhere, Mr Wanless, decreed there would be no more staff in any branch, no staff at the end of any phone, no person to see or be seen by, just machines, and phones that do not answer, and a solitary customer relations officer who wouldn't know how to relate to a customer if one ever extended a hand in simple gratitude to her (which none ever will), and if you do not care for those then go hang yourself but don't expect the NHS to pay for your fractures if you fall before you choke.

Doubling spending on information technology is Mr Wanless's solution to our ills. You can hear the killer-banker in that. Fire the staff. Invest in the machines. Put a technological barrier between the organisation and the customer. IT - the great Hadrian's Wall, keeping the corporation inviolate and the victim-supplicants for ever in the dark.

Another Wanless wheeze is to charge us when we fail to keep an appointment with our doctor. As though there is one of us who doesn't treat like gold dust the only appointment we can get with our doctor in a decade. But a banker knows what works in banking. Charge us more. Give us less.

It is axiomatic in all institutions and corporations of a certain size, that the more of a dog's dinner you make, the more they like you for it. And if they like you enough to parachute you down in millions, you can't really (can you?) be said to have made a dog's dinner after all. Thus do riches confer sagacity, and thus are we in thrall to corporate man.

But the NHS would do better to attend to the likes of me. Last week, walking in the oil and garlic of a Spanish downpour, I lost my footing and went over. Another casualty of age and body mass. But did I break? Oh no, I did not. And why didn't I break? Not because I had performed slow-mo geriatric gymnastics to Mantovani the day before, but because I was carrying a voluminous paperback novel - never mind the title - and because I had the presence of mind, as I toppled, to jam the 700 pages between my bones and the promenade. Not a bruise, reader. Not a mark. Lesson - never go anywhere without a work of literature.

Now which banker is going to tell you that?