Welcome to this edition of the Future Healthcare Journal ( FHJ ), my first as interim editor-in-chief. I must start by expressing my thanks and appreciation to Wing Commander Ed Nicol from whom I take the baton. Through his efforts, the journal has progressed, expanded and enhanced its content and readership. The phrase ‘a tough act to follow' was never so apt. As I move through my career I am realising that if we are to have a health service fit for purpose, an active informed debate about the future of our healthcare services is essential. My perspective on the challenges faced has been greatly enhanced by an unusual work pattern. I divide my time between serving the rural population on Orkney as a general physician, and my role in the cardiology team at Imperial College, London. Our aim is to …