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Surgery rates were reduced, and there was an apparent improvement in the equality of care, but our results do not provide information on quality of care delivered by either general practitioners or surgeons. Adherence to watchful waiting principles may have promoted more appropriate (and reduced) patient selection; alternatively, primary care physicians alerted by media concerns may have reduced referral rates. Establishing the link between health service activity and quality of care remains difficult.

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So after six days of sustained assault by the world’s fourth largest military power on one of its most wretched and overcrowded territories, at least 130 Palestinians had been killed, an estimated half of them civilians, along with five Israelis. The goal, Israel’s interior minister, Eli Yeshai, insisted, had been to “send Gaza back to the middle ages”.

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After 1943, Germany’s investment of more energy in the war effort was not only a waste it was almost pure downside. Of Germany’s 5.5 million war deaths, most came after the war was effectively lost. The payoff from every ounce of strength, resources and energy devoted to the Wehrmacht after the battles of Stalingrad, North Africa, and the defection of its Italian ally, was needless death and destruction leaving Germans poorer and fewer than they had been before.

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