A national supplies system can take many forms and there is no need for a soulless uniformity imposed by a dictator in Russell Square. There are local needs and circumstances that must be handled locally. Criteria about the welfare of patients involve consideration of the availability and suitability of existing products and services, and there is evidence of considerable efforts to consult users and, indirectly, consumers. The welfare of suppliers is equally important because they must be able to fulfil their primary function of making available the goods and services the NHS needs. The most important need is genuine collaboration between the NHS and suppliers. The DHSS has a formal responsibility to do this but its repeated actions demonstrate that it cannot bring it about; by convention, Treasury rules, political timidity and perhaps legal constraints it persists in seeing the NHS and suppliers as different responsibilities, with suppliers very much as afterthoughts.