Health and health care are increasingly big business. The challenge is to apply our knowledge and skills to meet people's needs, if not their demands as efficiently, effectively and beneficially as possible. "Value for money" is the slogan. For those who deliver the goods as required, the converse. "money for value" should equally apply, and not only in a market driven system. This paper offers a very personal view of these issues in the light of recent UK policy developments.