Okay. Good morning everyone. Welcome to this glass on understanding the prophetic, which is what we're doing first and then of course we will be touching on the apostolic ministry So let's begin with the word of the prayer. I'll lead in the prayer Heavenly Father we thank you Lord for this great opportunity Lord that we can study the word of God Father we can Understand Father God your heart behind the prophetic ministry Lord. Thank you that you are equipping us and Lord this is a prayer that Lord the power of the spirit Lord that it'll be released from our lives and God that mighty works Will be done Father God for the glory of your name Lord even as we Sit under this teaching and hear the word Lord. I pray that you will stir us up Yes, Father. God we want to be stirred up Lord at the work of the spirit Continue in our hearts father. We receive it by faith We speak a blessing or God upon these sessions and everyone who's a part of these sessions in Jesus name. We pray Before we get into Today's topic about the prophetic in the Old Testament I just want to hear from us if there was something new that picked up in the last class If there was a thought or a concept which you thought oh wow, I didn't know that So it'll be nice if you could share and we will continue from there So basically we talked about What the prophetic means the prophetic progression we also looked at how God Communicated to his prophets in days past and we saw how some are the process that some Receive a word more in a visual manner. Whereas some others may receive it in a sort of Inspired manner. So these were broadly the main concepts that we touched on. Yes, Jafina, please go ahead Yeah, I loved how we studied that there's a difference between a prophecy and believer prophecy ministry and Office of the prophecy that was something different for me something that I never knew and And I also loved how we started the class like when you asked why prophetic ministry I was thinking about so many things, but then you just said because our God speaks. That's a very simple answer Because our God speaks So yeah, these are things that stood up to me Thank you, Jeff, you know, thank you for sharing that any any other thoughts the others can If you would like to Anything that you picked up that touched you in the last class All right, so let's continue. I'm sure You know God will keep adding to the truth that we have learned so far. Please follow along By using the APC publication understanding the prophetic. So now we will move to chapter 2 in that publication It's called prophetic ministry in the Old Testament So God we said that he is speaking God He's always spoken in just past. He continues to speak to us today But how is it that he has spoken in In the Old Testament or in the Testament and it's not just about speaking but we are looking at the prophetic the prophetic Which includes includes the communication from God Many different things even discernment that God grants. So broadly the the the broad Prophetic gifts as well. So how did all of this work under the Old Testament is our question? See one of the important things that we all need for our lives is guidance. So even In the Old Testament, we find people Going to God to get answers God, what should we do? How should we approach a certain enemy or What are you saying in these circumstances these these are the questions people had and they always reach out reached out to God to Find the right answer. So How is it that God revealed his heart to the people? There are a primary way that we see In the Old Testament is through the urine and the Thumbim. Okay. So what are these things you know urine and Basically what God told Moses is he gave him an instruction to make these priestly garments and all the breastplate Right. He he said that you've got to put some stones known as urine and thumbim and These will help in God God Specifically sharing what he wants done to the people. So how exactly would God who's the urine and These these questions are asked the urine and thumbim are generally interpreted as lights and Perfections are also known as revelation and truth So what could have happened is that God could have Directed the priest as he stood before God As maybe some, you know, light shown on Either the urine or the thumbim to say, okay. Yes, you can go ahead or no, you can't go ahead This is right and that is wrong. So maybe some sort of a reflection on these stones could have Spoken to the priest and then he communicated that message to the people or It is also said that you know, they would put these stones in a pouch and then ask God God, what is your your decision? And then God would As they retrieve a particular Stone they would know. Hey, it's a yes from God or it's a no from God So this is the manner in which people went about Inquiring of the Lord. So you see the use of the Guru and so quite a bit in the Old Testament by various people, various people in different points, but today as we look at our own lives We don't do this at home. Some people say things like Bible Cricket You just open the Bible and then if God Points you to a positive scripture, then he's saying yes or if he's pointing you to a negative scripture that he's saying so, you know, we don't try to hear from God like that and We don't do things like okay, if if You know some small Please before God put it out there and then if God does this then you know He's saying go ahead or if he's not doing that then he's saying don't go ahead So we don't try to get answers in that way or even what I said about, you know, retrieving a particular Stoborn on in the Bible times We know that people used to cast lots even when they threw Jonah in the water That was a common practice because they believe that God would speak even through that Chants and probability as they picked that what a one name God's decision to be a But today we won't depend on things like this because we see in scripture and Colossians 3 15 It talks about the peace of God Peace of God in our hearts, which is the best indicator. So How do we know how does the New Testament believer or the New Covenant believer know what the Holy Spirit is saying God is saying you go back to the peace in our hearts, right? So we're walking the Lord we Know the Holy Spirit will pour in peace if it is the right direction that we're taking or It might be the other way around if it's not In line with what God wants us to do we might find that we're feeling very Disturbed and it's not just about an emotional Anxiety of disturbance, but deep in our spirit There is an undress and so the peace of God is like a compiler It's like our current day you driven through which God Guides us and shows us the direction. So I hope you're all with me. We're trying to pick up a couple of Insights from the way God communicated in the Old Testament. So it's a journey Okay, and we will look at the different ways that we're used So the first one is of course you remember them, but we don't really use it anymore What else what else do we see in the Old Testament? We also see that a popular way in which people Got a word from God was through a Profit okay, remember we discussed the seer Roy was they now being there were profits and those times who are anointed by God and they would hear from God and That was how a common person a normal person would want to hear from God So if they wanted to know something they would seek out a profit and Go ask them. Hey, what should we do? So, we know that in the book of Samuel you see great examples of this So I'll quickly read from first Samuel chapter 9 verse 9 says formally Israel when a man went to inquire of God He spoke thus come let us go to the Seer remember they call the prophet this year for he who is now called a prophet was Formerly called the called a seer Okay, so that's outside of The facets anyway, you understand that The prophet or the seer was the best cut to God and it was customary to Reach out to a prophet. So again, there are examples. We said that Saul When he lost his donkeys do he went to the seer and Their Samuel told him where the donkeys were but he shared much more than just where the donkeys were but regarding the Plan of God for Saul's life. There is another time where we see You know certain kings they approach Elisha Okay, so they come to Elisha and they want to know how do we go into battle? So then Elisha seeks the Lord and then he reveals the heart of God to the people So this is the manner in which you know the Enquiry unto the Lord was made now if you compare it to two types You know many believers asked this question. Should I go to a prophet? I am going to make a big decision in my life Maybe I should seek out a powerful man of God or a powerful Woman of God and they will be able to communicate what God wants me to do But you see this is more like an old testament Old testament How do I what do I say for this like the primary way in which people heard from God in the Old Testament was through a problem Okay, but that is not the primary way in which God speaks to us today So when we have to make decisions even Big decisions in life that can You know change the course of our lives. It is not necessary to hear from a prophet Okay, so note the words. I'm saying it's not the primary way. So would it be wrong to then Hear from a prophet at all not at all if over and above God's Direction to us in a personal way is confirmed by a word from a prophet Thank God for that, but that's not how We are going to make the big decisions of our lives We don't need a prophet every time to come and tell us You know who to marry where to live which ministry to do which city to work in No, we don't need a prophet for that. But what do we have right now as believers That you know, we have the inner witness of the Holy Spirit remember we talked about peace That is an empire in our hearts as Colossians 3 15 says but we also have the witness of the Holy Spirit So the Holy Spirit bears witness with our spirit when we are making a decision The Holy Spirit is able to help us and guide us again that sense of hey This is the best decision to make or that sense of something is wrong You know, even though everything looks good on the outside Something is wrong with this particular decision. The Holy Spirit can communicate directly to a believer. So we Primarily rely on the guidance of God's word and his spirit in addition to that If at all a prophet speaks over our lives and confirm something.  It's like a bonus. Okay, but like the Old Testament. We don't have to go ahead Run behind prophets to make decisions in our lives I really hope that it's clear and helpful at any point if you have questions, please Interrupt you can it's best actually for you to unmute and ask me because I'm looking at the notes So sometimes I there's a delay in me noticing the chat comments. Okay, so let's move on So what is the most important test of an authentic? Prophetic word let's say a prophetic word has been released. Okay, and how Would we know if that word is Really from God. So when I say it's genuine. It's authentic. It's really from God. Yeah, how do we know that? So in the Old Testament, that is something that God Instructed regarding the prophetic word. This is a Deuteronomy chapter 13 versus one through five If one of you can turn to this passage and read it, I'll be very helpful. Deuteronomy 13 versus one through five, please 13 verse one to five.  It's done. It's fulfilled. Okay, but even when it is fulfilled What does God say? Okay, you should not listen to the words of that prophet or that dreamer of dreams for the Lord Your God is testing you to know whether you love the Lord your God and fear him and keep his commandments and obey his voice so notice the Fulfillment somebody because in our understanding Prophecy or prophetic word is just that Someone said something that has happened. Wow It's authentic. It's genuine. It is from God. That's how we assess it But you see the Instruction that God is giving God is saying the quality of the word Okay, should also be considered. It's not just a fulfillment of the word So here the dreamer of dreams or the prophet what what did they prophesy? They said let us go out the gods. So the prophetic word in itself The nature of that prophetic word is taking people away from God though. It is fulfilled It is taking people away from God So that kind of a word is not honored by God So no wonder who God is actually warning the people and saying don't just go by a word being fulfilled but See whether that word is drawing you closer to me or not if The prophetic word or the prophecy is taking people away from God You know away from honoring God in their lives away from the plans and purposes of God for their lives It's not an authentic or a genuine prophetic word As far as you know this this passage is concerned So we must test everything that is heard even in the Old Testament God told the people look you got to Look at the prophetic word. Okay. Is it in harmony with? the revealed council of God so far, right? That is of primary importance as compared to whether or not that word is being fulfilled and so the same application Is helpful today. No, we look at the integrity of the word. We look at whether or not that word is Aligned to the locus. Okay, the word of God Whether it is expressing the will of God the purpose of God and drawing us closer to God or not So that is a test actually that we must apply on every prophetic word Okay, so We've learned a couple of things so far. We said that initially it was the Eurymentum in and then the prophets That's how God communicated but in the new covenant. We have The Holy Spirit with us. We have the inner witness of the Holy Spirit We have the peace of God that can help us and also we've seen how we must understand the Integrity of the quality of the prophetic word and That should be above just checking whether the prophetic word is fulfilled or not So what are some of the other insights we can gain from the Old Testament? So when it came to the prophetic word We also noticed that the prophetic word was not just something that was Spoken you know like like Like like a prose. Okay, just like an essay. Okay, this is how it should be every time that says the Lord and Communicated in that manner. So you find creative Expressions of the release of the prophetic word. So what do we mean by that? Now when we read The Psalms We find so many different passages there which are written in the style of song or poetry And it's so beautiful to notice that there is prophecy In many of them and how is it expressed in the form of poetry or song? So, you know, sometimes David is is writing about his own life. You know, he's saying It seems like God is speaking to David that now you will not miss The Lord spoke to my Lord so many different things like that But then those words were actually talking about the Lord Jesus So there is that prophetic insight even though You will find that it is from a person's life or you know, a person's expression So creative forms of expressions we we notice in the old testament. So we might find Some parables no here and there that carry some insights in them or some form of Symbolic actions symbolic actions where Jeremiah he he does something or is a kill is taken to some place and It's sort of dramatized. He was a life There is a lesson to be drawn about Israel and God through the life of Hosea So there are various ways in which you know the Direction and inspiration of God was brought up Even if you consider the life of Moses Moses writing a prophetic song of blessing 33 Correcting David see Nathan knows that David is wrong and he wants to release the word of God over David and say hey come on This is a mistake. Okay, you need to repent But instead of saying dust as the Lord you see the creativity that United goes in a rates story today. He said, you know, so there was this man and he stole the eve of Another man, so he just makes this the story and then asks David for his You know his final word on who's right?  He's bringing correction. He's bringing the prophetic word, but he's bringing it with incredible wisdom So in the Old Testament though somewhere we have this understanding that all the prophets who spoke only said dust as the Lord It's not true. There are Poems there are songs there are insights from people's lives that are parables. There's drama. There's you know wise Expressions of the prophetic word and so there are many things that we can actually learn from And God is actually speaking through all of these So that again is an insight that we can gain now moving right along in the Old Testament We also notice that there is some kind of an association of music with the release of the prophetic That is a particular You know incident and this is when Saul okay, Saul Who was anointed by Samuel to be king? We know that the anointing on Saul's life was a kingly anointing but When Saul encountered a company of prophets in first Samuel 10 and verse 5 What happens is it's it says That later when he encountered this company of prophets he himself began to prophesy So how can somebody with a different anointing? begin to prophesy It's incredible. So something with the The company of prophets and they are described as people who carried Tambourine, flute, harp and things like that and they were prophesying Okay, and obviously we learn later on that there was also some sort of An influence there which gave up on Saul and he was prophesying, but Primarily this company of prophets had a practice of incorporating music Okay, along with their prophesying. So there is a connection there music Prophecy later on again in the case of Elisha There's a time in second things three where you find three kings going to Elisha the prophet and they wanted to prophesy but at that point He doesn't have a word from God, but he knows how to get a word from God And you know what he does he calls for a musician So look at the scene Elisha He needs to speak to these kings He doesn't have a word from God, but to get that word from God. He calls a musician and Musician hasn't he must have been one of the sons of the prophets Okay, those days they had something known as the schools of the prophets where you had all these trainees Who would join to learn about the prophetic? So maybe one of those people who again like how we saw company of prophets with Tambourine and strings and all that so there must have been one of those trainees or students who's already used to Music and music instruments. So Elisha calls one of these guys and he says hey, can you play for me and when He starts playing The prophetic anointing is stirred up the Elisha and you know, he begins to prophesy Second Kings 3 verses 15 and 16 it says then it happened when the musician played But the hand of the Lord came upon them and he said thus says the Lord see how it's flowing, right? so prophecy seems to be associated with music in some places and It seems like the prophets knew how to make use of this Association so they would have that music and then the anointing would be stirred up and they would start to flow in the prophetic anointing so What can we gain from this today? we too can Make use of Worship, you know of praise And the anointing comes with it and Definitely as as we are flowing in those things the prophetic anointing will also be stirred up Within us in our congregations. Okay, so that's how we apply it in our today's life So, let's move right along We've seen all these things in the Old Testament Now what else what else can we see as far as the prophetic anointing is concerned, you know the prophetic anointing seems right now we said music and Prophetic anointing have a connection Okay, the next point is there seems to be a Connection of super natural demonstrations with the prophetic anointing so The people who carried the prophetic anointing over their lives don't think about Moses Okay, he had some incredible experiences That he walked through. You know, he got gave him the rod He went up to Pharaoh. He was able to face those sorcerers He raised that rod and you saw the you know putting up of the Of the Red Sea so there were incredible supernatural Demonstrations through the life of Moses. Okay, you could even call them like, you know signs wonders and Moses was walking in those things Because the prophetic anointing was was something that he carried now not just Moses think about people like Lighter okay, think about people like Elisha clear cut these were all prophets of God and as we study about their lives There are many many examples similar examples like Moses and even new ones so you had Bronze Okay, wait a moment Elisha using Elijah's mantle part the river Jordan is similar to what Happened to Moses no parting of a water body. We see other things like Material items Even something like Elisha's bones right was able to raise a Dead man and many other miracles, you know the woman of Zeraphat, you know how God divinely provided for her when The prophetic word was spoken by the Lord through Elijah into her life We also noticed the healing of a man called Naman leprosy very In those times of course, you know incurable disease These prophets the prophet Elisha in this case he gives him a simple instruction. He says you go you dip Seven times in the river and you will be fine so this Syrian he actually follows that instruction and Something like leprosy leaves his body. These are all supernatural demonstrations of the power of God and That is something that we notice through the life of Moses or Elijah Elisha And even today, you know, how do we apply this in our own lives? God could do supernatural things just to kind of Summarize some of the things that happened supernatural deliverance people that brought out all the miracles of Moses and all that Supernatural deliverance could happen miraculous childbirth could happen. There were you know, women who did not have children You had these prophets prophesied so supernatural miraculous childbirth or multiplication of food and oil or Causing fire to fall out of heaven Outrunning the chariot right physical with the physical strength that Elijah had or Or Something that went against nature. You had an axe head which was floating in water against something supernatural Causing of supernatural blindness the filling of ditches supernatural death Cancellation multiplication of oil in the jar. So the list is you know, sort of really long if all those things could take place under the Old Covenant through the prophetic anointing, you know, how much more because we know that we are in a more glorious Covenant and that is an encouragement for us that today Nothing should actually stop us from the supernatural Demonstrations of God and there is an association of the prophetic anointing with these supernatural demonstrations. So as we are growing In the flow of the prophetic You and I can exist. If God did it in the Old Testament times He can definitely do these wonderful miraculous things So I know that we asked a question in the Mentoring art and her question was about the greater works in the greater works that Jesus said you shall do greater works So a simple way in which it would probably be addressed in the supernatural But briefly I'm just sharing when we look at the life of Jesus All the works that he did Okay, so today we can see a greater measure Like in terms of numbers The work that we can do for God We can see more of those works being done. So that would qualify as great works and Maybe even some things that could not have happened during Jesus's times. For example, in those times we did not have Medical intervention where people People were Given metals in their bodies, right? Like today we have that we metal Replaces born and you know people are able to function With their bodies normally after that but Today that we have a practice like that even something supernatural like the bone the metal turning into bone You see, so that's a greater work Because we haven't there was no Opportunity for such things when Jesus was walking here not to say that oh, we are greater It's not like that, but it's just something Incredible which you've not seen happen in the past that can happen today So those were the things that Jesus was referring to as the greater works of God and I really hope that addresses You can please go ahead. Yeah, thank you I just had a question regarding this course itself In terms of Okay, the prophecy in the Old Testament times Just as you were mentioning and when Jesus Christ came he himself is like that fulfillment right of all those prophecies and even if we see the New Testament we have like major Like in Revelation and all even whatever Paul talks about rapture and yeah, there are some prophecies of those sort so What what else is there to you know to be revealed like everything is laid out in the scripture. So my question is If if I just had this question because when you said that Nowadays we will we want need You know somebody to tell us which place to in those in a small details of our life Yeah, we don't need any prophecy because so I was trying to understand the Why prophecy because then everything is laid out in the scriptures. It is Revealed to the end So then where does this come sin? Yeah, I Know that prophetic ministry is Mentioned in Ephesians So yeah, but I'm trying to understand better like where in it applies Sure, we are good really good question there and as I pointed out today We are not just limiting ourselves to Prophecy, but it's about the prophetic anointing as a whole and as We have discussed right now You know, we saw how the prophetic anointing is associated with supernatural demonstrations as well You know hearing from God and speaking that word cost supernatural demonstrations as well, so we are actually talking not just about Hearing from God alone, but the prophetic anointing. Okay, so I'm just clarifying that before I Specifically answer your questions. Your question is Jesus already came and you know He he is a fulfillment of what we have been promised in the Old Testament And he has already revealed many things and of course we have the word of God and as I was saying the Holy Spirit is at work in us So why prophecy? Okay, why should we? Even have this option of God speaking through prophecy a prophetic word or through a prophet So the via even though we have the word of God with us And we have the Holy Spirit living on the inside of us you see when we talk about the the Understanding of God's word and the application of God's word for us to live aligned to The purposes of God Not everything is clear. Isn't it? We do Have questions even though we need the word and the Holy Spirit is Clarifying many things to our hearts there are still Matters where we need God to shed light Okay, and if that were not so God would never have given us This gift of prophecy Gift of the Holy Spirit you would have never even mentioned it to us, but there is a place for God to speak Through the prophetic word through the prophetic Unmending and we need it. We need it and that is why it is still available to us Okay, now having said that I just want to clarify the prophetic word is not above What has been revealed to us? By the logos or the written word of God at the Holy Spirit who are Harmony So they are in harmony. So the Holy Spirit will not because we're saying prophecy is a gift of the Holy Spirit the Holy Spirit will not pull in a direction which is Different from what the integrity of God's word really is in one John 5 7 we see this so There is a need so that's my answer That's my short answer to you Divya There is a need for a there is a need for Prophecy and the prophetic anointing in our lives even after we have the written word We have Jesus who has already come and when we look at the prophetic word the prophetic word will not No say anything outside of the integrity of the written word and the agreement of the Holy Spirit So there is a need that is the reason God continues to Continues to You know release this this gift to us Does it answer your question? Yes. Yes. Yes, Pastor. Thank you so much. I have Subsequent questions, but maybe I can ask later also Okay, okay. Sure. Sure. Yeah, sure. So see Though we are saying that the Old Testament practices are now Replaced in a sense by the work of the Holy Spirit who indwells us And of course the baptism in the Holy Spirit that the believer can can receive We are not saying that God is done away With the prophetic anointing. That's definitely not what we are saying The anointing still exists. There is a need For this anointing the prophetic word and God will be glorified See when we study about the gifts of the Spirit, we also see that statement No, but we see that the manifestation of the gifts of the Spirit is for the benefit of all So there is a benefit through the prophetic word in Existing times in the current times and which is why God is Continuing to equip the church In the work of the Holy Spirit Okay through the gifts and let's learn let's continue to learn and yes as we go forward if there are Other questions that come up you can ask Okay, so all right, so we'll move on that we have about Five minutes. Yes. Yes, Divya. Oh, no, I'm just saying thank you. Oh, okay. Sure. Yeah, thank you So fine. So we've seen miracles and supernatural demonstrations Being associated with the Prophetic anointing. Okay. So what else is there in the Old Testament? We see a concept called as the school of the prophets. Now, this is a very very interesting Concept Where did it begin it began during the times of prophet Samuel? If you remember Samuel as a child when he was dedicated and given to the temple God spoke to him. He heard the voice of God. What is her hearing the voice of God the prophetic? So Samuel is hearing the voice of God and he doesn't even know that he's hearing the voice of God, but he Had Thankfully an elderly more experienced priest in the temple by the name of Eli obviously was old by this point And he was not able to fulfill all his responsibilities in the temple But I think that Samuel could pick up And when we study the first Samuel the Bible does suggest that this season that Samuel was in Was spiritually dry the Bible says something like it was not common for people to hear God's word Okay, so Samuel grew up in a time when he lacked Opportunity to be properly trained hearing the voice of the Lord He did pick up a few things from Eli and he you know continue to grow in these things and hear the word of the Lord But when he finally Came into the fullness of this calling he Established something known as the schools of the prophets. So we'll talk about these schools Why did Samuel establish these schools? Maybe because he lacked that proper equipping But even though some attitudes about the Samuel to really applaud See Eli, he was old and He wasn't You know fulfilling all his responsibilities in the temple yet Samuel Whatever he could he learned from Eli. He did not despise Eli for years. He faithfully served under the Mentor that God gave him and God is so faithful God is so faithful that God continued to nurture Samuel and Samuel Rose up as this mighty prophet Profitic anointing upon his life and he started these schools of the prophets Maybe the intention that he wants to impart to the younger generation what he lacked So in the school of the prophets, we know that there were men Primal, I think men because I don't see any reference to women So men who went trained to hear from God So as you study about all these people we saw how there was a company of prophets Where did this company of prophets come from likely the school that Samuel established during his time and Notice how they were carrying instruments. So he was actually Trading them whatever he knew about the prophetic and the associations of the prophetic He was trying to impart to them so that they can flow in a greater way in the prophetic Anointing so that is how these schools actually started. So maybe people would have joined it stayed with Samuel and Gained from the inside. So you see a progression from there. You see People like Elijah And suddenly you notice that Elijah has a servant called Elisha and Elisha is tagging along with Elijah And you know at some point desiring the double anointing Which Elijah where did all this come from it may have started from this whole training that Samuel Gave birth to and then it continued continued. So senior prophets would take on mentees and Equipment in the things of the prophetic Anointing and the and the next generation was able to move flow more powerfully in the prophetic Anointing you know Elisha again. He had Gehazi. So who are all these people? Training training was going on for the particular Elisha called somebody to play a musical instrument Training equipping. So what do we learn from this? We learn many people would say at see the gift of the The gifts of the Holy Spirit are from the Holy Spirit. Okay, then what why are people trying to have? Schools for learning about the gifts of the Spirit or you know talk about a training seminar Conferences that equip people on the gifts of the Holy Spirit It shouldn't be so no because it comes from the Holy Spirit and we have the Holy Spirit and Holy Spirit can train us But you see here. Yes, the origin of the gifts is from God but man can play a part in equipping and training others, right, so Believers can be trained by other believers or leaders in the body of Christ to flow better in the gifts of the Spirit and We're talking, you know more specifically About the prophetic anointing and prophecy. So that's the point that we keep all right So I've taken a little extra time here. Let's go in for a break We shall come back at 10 or two and Pick up from where we have stopped. So please don't log off from the call I can see on the call. We'll connect back on the same link. Thank you See you soon


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I think that what the issue is around now, and I don't suppose to have the idea about point in time and some time, but now functionality of relying our separate, it justifies our shortcomings. It's all we can relate to and identify our shortcomings as being, oh, well, it's just because I'm feeling this self-feeding. So there may be the question of the chicken and the egg as much as which came first, you know, the mistake or the belief of making the mistake, and that's kind of a little point in the play of ideas. But I think for me, that's how it tends to function. You know, getting back to how this continues to be supported and how it interacts with our thinking. When things go wrong, when things are less than perfect, we have a rationale, which is, well, what he expects. Those thoughts are like held on in the mind to justify the experience. And after a while, you know, you start to get wise to this. It's kind of like, am I going to continue to use these spear-based thoughts to justify my experience.  And I don't want to continue to use, to justify my thoughts. If I'm feeling angry, the ego is saying, yes, yes, you're feeling angry. Blast it out. Project a blame out there on something or someone else in some situation in the world. It'll make you feel better. You'll get rid of it by giving it away. You'll kick the dog, do this, do that, but just get it out, you know. And basically, what the Course is saying is, the projection doesn't work. That it's like a boomerang.  And so after enough times of throwing the boomerang out and getting, getting walked in the back, it's like the mind starts to say, there's a trick here. There's something that's not going right here when I keep trying to project these things. Now, if you get to the metaphysics of this, basically there's one law in heaven. It doesn't make it nice that it's real simple. The law in heaven is what you extend you are. So when God extended himself, you know, love, then what you extend you are. His son has the same thing as when you extend love, you are love. So Jesus says, when you come down into the dream world, it's just a misapplication or a distortion of this one law that's in heaven. And what it comes down to when it comes through the ego lens, is what you extend you are in heaven comes down the lens. And it's like you're looking through a lens that what you project, you will believe. So if I project a world out there, I try to get rid of this world out of my mind. I try to get rid of this duality and this split in my mind and I project it. As soon as I project it and I believe it, it sure seems believable, doesn't it? Doesn't this body seem real? You know? And the whole point is you have to question the beliefs and the thoughts because you have to start to see that they're attack thoughts, that they're unreal. As soon as you can start to see they're unreal, then you don't do the best in it. They're false. You pull your mind away from them. But as long as you believe they're real, it's like, oh my gosh, this is horrifying. Project it out. Then I continue to see events that seem to be like I'm a victim. Like something's happening to me. There's so many backward thoughts in my work. Like I said, it feels like when I start looking it feels like a lot of them are backwards.  Then you're not seeing any projections around you. You think you're hiding from them. But then you get to the point where you feel alone. What is that? The backward thoughts. In other words, you can remove your body from society. You think you're removing yourself from the things that are bothering you. Because you think that's where the cause is. But where's the cause? The cause is inside. And you don't remove yourself from your body. So then you get back in there and you... What's pulling you back to that? What is it? The action. Well, in a sense, the Holy Spirit, I mean, people will say, what's the difference like with Mother Teresa going around and seeming to reach out to everybody versus, let's say, a monk or one of these mystics that goes off to the mountain? In a sense, Jesus is saying, as long as you're training your mind and you're trying to detach from these thoughts, I mean, the form is irrelevant. We all have very high functions. We're called to be teachers of God. We're training us. All of us. And we all have a lofty function. And the more we really give our minds to that function, the more we really start to live it and practice in everything, there comes such a joy that it makes you forget about the candy bars, the jelly bars, and the whatever, you know. It's like before she was inconceivable to be without the Hadzpah Sunday. You know, it's kind of like, I like my Hadzpah Sunday, Jesus. But what happens is, more and more, when you get into this function and purpose, that it just like, there comes an intrinsic joy. It's like a well that bubbles up from within the mind, from the Holy Spirit. So you don't have that emptiness that you're trying to fill all the time with all these other things that don't really work. Right. Now you can take these things, and instead of trying to wrestle with them, there's like little flakes of dandruff. Here we go. You've got to blow them up, you know. That's the way to let go of things, to blow them away like that, like those little pieces of specks of dust, instead of like their giant leeches.  I suppose the more you validate them or focus on them, the bigger they become.


So we're finally ready to be able to make some predictions about real chemical systems by asking which macro state is the most likely one out of all the ones we could consider. So the question we're really asking is if a particular combination of molecules in a particular collection of states is going to be the most likely one, it's going to be the one with the highest multiplicity, the one with the largest number of ways of making it happen. As we've seen when we talked about lattice problems, for example, but we have one slight problem which is the multiplicity is in a terribly convenient problem. So that's why we went to the trouble of defining this quantity we're calling the entropy, which is the log of the multiplicity. So whenever the multiplicity is large, the log of the multiplicity will also be large. So asking for what macro state has the highest multiplicity is equivalent to asking what macro state has the highest entropy, the extensive entropy, which is equivalent to asking which macro state has the highest entropy per molecule or per mole, the molar entropy, or while we're at it, that's also the same as asking which one has the highest entropy when we divide it by constant, Boltzmann's constant or any constant we wish. So we can maximize any one of these properties, whichever one's most convenient, and it turns out the most convenient one for us to maximize is this probabilistic definition of the entropy. So if I sum up P log P probability times the log of probability for every different state the system can exist in, every different confirmation, every different energy level, whatever the states are that we're talking about, then that's the thing I want to maximize, negative some of these P log P's. But we've learned that we don't actually just want to maximize the entropy, probabilities have a special criterion they have to obey. If this is the function we want to maximize, F is minus the sum of the P log P's, there's a constraint, which is that those probabilities have to add up to one. So we want to maximize this function subject to this constraint. We've done this for the specific case of just two outcomes, heads and tails for example, but we're in a position now where we can do it more generally, where there might be ten different states the molecule can occupy, or ten different products that can happen in a reaction. So if we want to maximize this function subject to this constraint, we can use Lagrange multipliers to do that. So we're looking for the conditions where derivative of this expression with respect to one of the probabilities, maybe P1 or P2, we're looking for, let's use P sub j, we're looking for the derivative of F with respect to Pj minus Lagrange multiplier dG dPj, we want that to be equal to zero, and we want that to be equal to zero not just for P1 or P2, but for all of them. So what we want is j must be one or two or three or any of the possible states the molecule can be in. So we just need to take these derivatives, I'll write this out, derivative with respect to P sub j of negative the sum of all the P log P, so P i log P i summed up over all the i's, that's that first dF dPj, and I want to subtract lambda times the derivative with respect to P sub j of the constraint, which is just the sum of all the probabilities. So that's the thing that we want to be equal to zero, let's stop and make sure we consider how to do this, because if you haven't seen this very many times before, taking the derivative of summation notation might look a little intimidating, but really all this means, I'll write this out in a separate step. This particular step, for example, derivative with respect to P sub j for one of these j's, let's say P sub three, derivative with respect to P3 of this sum, that sum is just, so for example dP3 of P1 plus P2 plus P3 plus P4. The sum just means add up all the different probabilities P1, P2, P3, P4 and so on. Derivative with respect to P3 of that sum, none of those terms matter except the P3 term. And so derivative of P3 with respect to P3 is just one. So this derivative is actually quite simple in form. It's that derivative of the sum with respect to P sub j is just one. Whichever the Pj is, it appears in that sum exactly one time with no coefficients. So when you take the derivative of summation notation, you're just plucking out only the terms that have a Pj in them and taking the derivative only of those terms. Likewise, for the first term, the derivative with respect to Pj of this term. The first term P1 log P1, the second term P2 log P2, only one of those terms matters and it's the one with Pj in it. And that's going to give us minus log Pj minus one. Where that's the same derivative we've taken a number of times now. Product rule tells us derivative of P times log P gives us this. And P times derivative of log P gives us this. Both with a negative sign. So that's after taking the derivatives. Those things must be equal to zero if we're at a minimum. So if we are at the, and again, for j equals one, two, three, and so on. So for every one of these states, the log of its probability with a negative sign, minus one, minus a lambda, has to add up to zero. So rearranging that equation tells us log of Pj must equal minus lambda minus one. Undoing the log, Pj is e to the minus lambda minus one. This is looking similar, quite similar to the problem we did with a coin flip. The difference now being we don't just have two options, we have lots of possible options for what each molecule can be. So, so far so good. Each one of these individual states, number one, or two, or three, or so on, has a probability equal to e to the minus lambda minus one. Lambda is this Lagrange multiplier that we don't need to know the value of. Because the constraint tells us when I add up all of the piece of i's, P1, P2, P3, and so on, I should get one. The probabilities have to add up to one. So, adding up this value for P1, this value for P2, this value for P3. I'm going to get e to the minus lambda for each of these terms. If I have, let's say, big N different possibilities, state number one, two, three, all the way up to state N, then N different times, I'm going to add up e to the minus lambda minus one. So, e to the minus lambda minus one N times has to be equal to one. And what that tells us is e to the minus lambda minus one is equal to one over N. But e to the, and we could continue and solve for the value of lambda, but remember we don't actually care what the value of lambda is. Knowing that e to the minus lambda minus one is equal to one over N is enough information to tell us that since each of these probabilities is equal to e to the minus lambda minus one. P sub one is equal to this, P sub two is equal to this, P sub three is equal to this. All the probabilities have to be one over N. When I add them up, one over N, N different times, that gives me 100%. So, this is the answer to the question, how do I maximize the entropy? How do I, what is the most likely outcome if I have a bunch of different states? The one that maximizes the entropy is if every state has the same probability, N states each with probability one over N. For example, for the coin flip example, if I have two possibilities, heads or tails, the maximum entropy comes when heads happens one half the time and tails happens one half the time. If I were to roll a six-sided die, what's most likely, what maximizes the entropy is if one out of six of my rolls come up with a one, one out of six of them come up two, one out of six of them come up three and so on. Six different outcomes, probability of each one is one over six. So we've done a fair amount of work to derive something that seems pretty obvious, but we've now guaranteed that that is in fact what maximizes the entropy and that's the most likely outcome is half my coin flips will be heads and half will be tails. But notice that it doesn't seem to answer some of the more interesting questions, right? If I have, we know for example that butane molecules, one of the examples we've been using, at room temperature butane molecules have the 68% chance of being in the anti-configuration or confirmation, 16% gauche plus, 16% gauche minus. That is not one-third, one-third, one-third for the three different possibilities, right? Why isn't it more likely that the butane molecules will have one-third probability of being in each configuration? It seems from this math as if that would maximize the entropy, but that's not what happens in the real world. So we're not yet able to predict what's gonna happen for interesting systems, chemical systems like butane, only for relatively boring things like coins and dice. And the reason for that is we've included the probability constraint. They guarantee that the probabilities have to add up to 100%. But the thing that makes butane more likely to be in the anti-conformation than the gauche conformation is something to do with its energy. And we haven't included any constraints about the energy. So that's the next step we'll take is to understand how to predict what's gonna happen when there are constraints on the energy of the system.


Yes, so what we have showed today is a multi-slicing architecture with multiple core networks and how this can be easily deployed and customized for the different user scenarios and how it can be deployed. So at this moment we are supporting core networks. We are supporting media slices and IoT slices and this address the most of the use cases that 5G is about, including factory automation, mobile broadband, agriculture, and then also city-wide type of networks like smart cities and so on. Since more than 10 years at this moment we are working very closely with operators, vendors, startups, SMEs and so on and integrators and we are developing different testbeds and prototypes together with them, creating a large sort of testbeds. We had previously Fusco Playground, now we have the 5G Playground. We bring together solutions of different partners, create innovative products, create innovative prototypes, new IPR and ultimately trial-out, make interoperability and all the testing. And this is the way to join us. We practically act as integrators of different components coming from different vendors and in the interest of different areas of the industry.


Like any song you want to play. Sweet. John, bass and vocals. I'm Lance, a drummer, and some of rap. Yeah. I'm Luca, I play guitar, and then I sometimes sing, too. And we're Loose Leisure. Hey. Yeah, we have six or seven originals now. Yeah. Yeah, but I'll let you guys talk the music we play. Mostly rock all over the spectrum. What's your favorite song? I like playing stroke songs and arctic monkey songs. I feel like when it has specific rhythms in a three-piece rock band or something similar to that, it's pretty good. We like to do Jimi Hendrix for that reason, too. So yeah, I don't know. We're kind of all over the place, too, because our originals are pretty jazzy. So I don't know. I guess our vibe is just like jazz rock. Favorite memory from Loose Leisure. That's a tough one. So we played at a co-op once, and we'd never played at a co-op before. Started off pretty light, and then a couple hundred people showed up.  And at this point, I've played a lot of shows, and they were just incredible. And it was precisely the feeling that we hope to give to every single crowd that we play with. So it felt really, really cool to feel almost like at one with the audience, which we sometimes get, we sometimes go in and out of. But for this whole gig, it was just like one big happy music family. My favorite memory. I think I got a pretty good one. So first semester, our last show, we played at the Davis Co-op, which was pretty fun. But then I started talking to this girl recently before, and I invited her to the show. And I really liked her a lot too. But also it was like my entire improv team all came to this show, too, because we had a show before. So it was just like all my favorite people at this one house. And it was like perfect energy for a party too. It was just going crazy. And then my improv team chanted, No Pants Lands. Because we went to a party together, and I woke up naked in the front yard like to be in the morning, which is a whole other story. How did you come up with your name? I'm actually really curious about this. I got to be done. So Lou was big on alliteration. And we needed band to be alliteration or something. And we were driving. After we were driving, we drove like a parking lot to drop John on somewhere. And we just sat in the parking lot. We're not leaving until we come up with a cool alliteration. And then we like loose leisure just came out of that. I don't know. I think my love for music goes more to like, I think I also like listening to music more than playing. When you play, you kind of like lose touch with reality. When you play for like an hour, and like you play, it feels like a snap.  It's crazy. Like that's what I kind of found out when it feels like that's like, oh, I don't really love doing this. This is really fun. And then, but like I can't be on Berkeley campus without headphones. Like I'm just always listening to music. My mom made me play a five-point one when I was five years old, freaking hated it for the longest time. And then I don't even know. I was like at this like violence summer camp. And there was like this dude who was teaching like guitar. And then like I just like took lessons from him. And like I thought he was like really cool. So I just like kept taking lessons from him. And then I like got pretty good at guitar where I could just like teach myself stuff. He started playing a lot of like frat parties and co-ops. We played a couple gigs out in Petaluma now. So we're hoping to try to start playing more shows at places like Cornerstone and stuff. But the frat co-op large group living scene at Berkeley is awesome. We love to play for any and all, but they'll have us. I started my first band in second grade. And when I was a second grader, it was my dream to be in abandoned college playing for y'all. So I like, to me, this is just like dream come true.  I'm so happy about it. What has Lucie's been to you? And how has it defined your college experience? Oh, easily the most fun I've had in college by like so, so, so much. Like I love these guys. I love playing music. It is like, of my senior year, at least this is gonna be the thing that I remember most, without a doubt. So it means the world to me. What does Lucie should mean to me? I think it's like, I don't know, it's definitely like family. You know, it's like, oh, I got these two guys. It's like, tell me anything. I don't want to be an adult yet.  Like, what's dumber than that? You know, like, my college experience at Lucie's here. So it's like kind of been like my entire college experience, which is really fun. Just like a massive source of good times. I don't know if that's the best way you could put it. I'm doing a double major right now. So like, it's like super stressful. So I need like these like outlets, you know, just like playing music with the boys. What's the future for Lucie's year? We're gonna play a lot of really good shows for the next semester. We'll put it that way. Maybe recording the visuals we got too. That's potentially gonna happen. Definitely. Don't tell them this, but I want us to make it big and then we all drop out. But when they're gonna be graduated, I'll drop out. But they want to give real jobs. This has been Audrey Jacobson and Ava Andrews for Cal TV.


Rwy'n meddwl i'r unrhyw gyd fel y dyflawn, y byddwyd i'n gweithio ar gyfer y dyflawn yn yng nghymru, mae'r presens yng Nghymru, Chris Martin, yw'r cyffredinol yn ôl o'r cyflawn yng Nghymru. Yn ymddangos ar y gyrsau cyfrifol yng Nghymru, rydyn ni'n ymddangos ei wneud o'r gweithio'r cyfrifol ar gyfer y cymdeithasol, sy'n cymdeithasol? Mynd yw yw'r amser ddim yn gwybod, yn fawr o'r cymdeithasol sy'n gwybod. Felly, mae'n gweithio'r cymdeithasolau. Ond yw'r amser yn ddigwyddio'r cymdeithasol ac mae'r cymdeithasol yma yn y dyfodol. Mae'r cymdeithasol yma yn ymlaen i ddiogel o'i ddefnyddio'r cymdeithasol. Mae'r angen ar y cymdeithasol. mae'r rhan o'r rhan o'r amddangos, o'r rhan o'r llwyffydd, o'r rhan o'r rhan o'r ddweud o'r hollol, o'r hollol o'r hollol o'r hollol.  Oherwydd rydyn ni'n meddwl o'r bethau, oherwydd mae'n meddwl o'r ddweud, ychydig i'r ddiweddol ar gyfer oes mwyaf o'r 2000 ysgrifennu anhygoel, when making health policy has been easier just as there has never been easy, just as there has never been a time when the delivery of health services has been anything other than a challenge. But let me give you one way in which 2014 is very different indeed to 2004. In 2004, we were just moving beyond the first term of the National Assembly, a term in which, in cash terms, the budget of the National Assembly and of the health service had grown by 10% every single year. We were moving into the difficult era of the second Assembly term when growth was being reduced to only 6% every single year. And budgets across Welsh public services, including the health service, grew in every year of the first three terms of devolution. And the fourth Assembly term is very different indeed in that way. The age of austerity in 2014 means that it is a year which is quite different in fundamental ways, despite the commonalities to what we faced a decade ago. And the effect of the age of austerity, the deep and sustained cuts in our public budgets, is a reality. It's a reality that impacts on the lives of individuals who work in the health service, and it's a reality that impacts on the lives of those who use our services too. And with a Chancellor of the Exchequer promising a further £25 billion worth of cuts, if he remains in office during the rest of this decade, it is no wonder that the Auditor-General for Wales has concluded that the financial outlook for public services in Wales is bleak. Now, as Chris has already said, and as I say wherever I go, there is no choice but change in the Welsh NHS. The only choice is between planned change, in which we attempt to take our destiny into our own hands and shape our collective futures, or change that will happen to us in an unplanned, unpredictable, ungovernable way. The choice is not between change and no change. It's about the sort of change that we want to have and how we go about it. And for this audience in particular, despite the scale of the challenge, there is no option to shrug our shoulders or to turn our backs on addressing the challenges that we face. There is no cavalry coming over the hill. Our destiny really does lie in the skills, the experience, the commitment of staff at all levels in the NHS. And we are hugely fortunate in having that enormous reservoir to draw upon. Just as we are fortunate, I believe, to have the maturing experience of devolution itself now at our disposal. And just to put some of the challenges we face in context, I want briefly to reflect upon that period. The arrival of devolution coincided with the end of a period of sustained under-investment in public services. When I became adviser to Jane Hutt in 2000, at a time when the National Assembly was not yet a year old, the public capital programme for the National Health Service in Wales was having to be re-established from scratch. There simply was no programme. In service terms, the failure to invest in the workforce in particular had led to real strains in areas such as mental health, waiting times for treatment, all of which was corrosive both of professional and public confidence in the service. And we should not forget the major achievements of the 10 years that have followed. In capital expenditure, there has been major investment in all parts of Wales and across the range of clinical disciplines. My old boss, Roderick Morgan, was fond of reminding me that the first time a commitment to replacing Caerphilly Miner's Hospital was made, was in Labour's plan for the Valleys of 1962. Now it only took 40 years and devolution to make that actually happen, but now it's there the change is made. I think when the history books are written, the first decade of devolution will turn out to have been a stand-out period for reinvestment in the infrastructure of health services in Wales. Now, of course, there is more to be done and despite the fact that capital expenditure is taking an even greater share of cuts than any other parts of our budget, we go on investing in the health service here in Wales and we do so moreover without the burden of PFI debt eating every year into the money available for providing a service. The annual cost to the National Health Service of paying PFI debt in Wales is a tiny fraction of that faced in Scotland. It is less than some single trusts have to face paying off annually in England. As repayments continue to rise elsewhere, so the comparative advantage we have in being able to use the revenue stream that we have in our health service to go on providing services rather than paying off debt will become ever more apparent. Just as we've managed to invest in the capital side of the service, so there has been major investment in services and revenue services as well, the number of doctors employed in the Welsh NHS after a decade of devolution has risen by 1,700. There is a 33% increase in staffing right across the Welsh NHS and it's not just a matter of the numbers of extra people who work in our service, but it's the nature of those jobs too. The ambulance service for example has seen a rise in staffing at almost twice the rate of the service as a whole, but in doing so it is remodelling its workforce so that it becomes that emergency medical service with a wider group of people able to provide clinical services to patients at the point where those are most needed. The last time I spoke in this very building was to celebrate the success that Wales has had in developing advanced practitioners, somewhere where we really do lead the rest of the United Kingdom. And while for the rest of the United Kingdom, 2013 was a year in which the aftermath of the Francis Review brought patient safety to the foreground here in Wales through the Save 1000 Lives campaign and its successors, we have already been engaged in that quality and safety agenda for many years. And finally in this rehearsal of the positives just to remind ourselves that we are in a period of essential structural stability in the Welsh NHS. We have a national service based on planned responses to assessed needs. We have integrated organisations capable of mapping patient journeys across primary, community and secondary care and to do so more closely than ever before with our partners in social care and in the third and voluntary sectors. Now it's not for me to cast aspersions on what goes on across our border in other parts of the United Kingdom, but in terms of structural stability, the contrast between the position we have in Wales and the turmoil in England could not be more striking. And I'm very pleased to reconfirm today that that period of structural stability stretches beyond us here in Wales. We will use this opportunity that we have to concentrate on the things that really matter and matter to patients. Now I mentioned at the outset the challenge facing public services in Wales is as formidable as they ever have been since the emergence of the welfare state. Any of us in the room who heard Michael Tricky at the reception last evening talking about the work of Wales 2025 will have been left in no doubt at all, but that really is the scale of the challenge. But I do say to us in this room that we do ourselves no favours, nor do we do justice to what has been achieved. If we talk ourselves into a cast of mind where because we live in Wales every hill is higher, every climb is steeper and where every second best solution is thus rendered acceptable. We simply cannot and will not consign the long term future of the NHS to the two difficult box because the daily fight for survival is all-encompassing. Now I have very few opportunities, stranger enough, to talk with an audience about some of the bigger picture ideas to stand back from the daily turmoil that goes with being involved in health to think about the future. And so I'm very grateful to have the opportunity today to begin a discussion in the Welsh NHS about some ideas that will help us to go on providing an equitable service for the future capable of being sustained even under the impact of the age of austerity. And as Nye Bevan himself undoubtedly would have said, it comes down as ever to the question of priorities. The NHS has always been clear that in urgent or unscheduled care prioritisation comes by clinical need. Lower needs are trumped by higher ones. Those who are in most urgent need get seen first. In other parts of the system however we continue to prioritise by time. Those who have waited the longest move to the top of the queue. Now it's my belief that austerity bites more and more, so time as currency in healthcare will become less and less useful or usable. Instead we have to find new ways of prioritising the services we provide and to align them and access to them more directly on clinical grounds. And that's why I am keen that the NHS in Wales embarks on shaping our future on the basis of the principles associated as Chris has already trailed with you of prudent medicine and prudent healthcare. Now for those coming across these terms for the first time I ought to make it clear that I'm not claiming any great originality for the ideas which I'm about to set out. The prudent medicine approach is already well established in some aspects of contemporary clinical practice in our own country as well as being widely rehearsed in other jurisdictions such as Canada. Here in Wales I'm indebted to the work of the Bevan Commission setting out the first concerted attempt to provide an account of prudent healthcare in the United Kingdom together with some opening thoughts as to how such principles might be applied to the practical business of providing health services. Now I'm going to try and do two or three things. I'm going to start now by outlining some fundamental principles, core principles derived from the work of the commission which I think sum up the essence of the prudent healthcare approach and then I'm going to go on to look at in a very preliminary way how those principles might be applied to the health services that we have here in Wales. Now the first principle is one which will be very familiar to you and which no doubt will seem uncontentious and that is that it is the first obligation of any service and of any individual providing that service to do no harm. And yet despite the uncontentious nature of the proposition we know that in practice avoidance of harm requires action across the whole system. That's why we have embarked on the Save A Thousand Lives campaign and its successors in the first place. It's why we continue to bear down with such determination on healthcare acquired infections here in Wales. But I think that we have to go beyond the do no harm principle to one which is focused on what is normally called minimum appropriate intervention. The principle that treatment should begin with the basic proven tests and interventions, calibrating intensity of testing and treatment consistent with the seriousness of the illness and the patient's own goals. How many times have we heard people say in Wales after they've had an encounter with a health service or they're trying everything they can do for me as though somehow volume of activity was the touchstone by which we measured our success. Prudent medicine provides an ethical underpinning for conversations with patients because who actually in practice would wish to undergo a greater level of treatment than that necessary for addressing their condition. It means that the conversation that we have with patients cannot open with the question what can I do for you as though the encounter is one in which the health service takes onto its own shoulders the whole of the responsibility for that encounter. The first question that we should ask I believe is that co-productive principle what can we do together to address the difficulties and the problems that you are experiencing. And if we do that then that principle of minimum appropriate intervention I think becomes part of a conversation which relies on reinforcing people's strengths and is always focused on maximising their own abilities. It's a very natural reaction a very natural human reaction when we see someone who is in distress or in difficulty to want to wrap our arms around them and say they there don't you worry we'll do this for you. And actually we know that despite that human impulse it leads if we are not very careful indeed to stripping people of their abilities to removing their capacities from them and in the short term expedient we end up doing long term harm. And on this point let me be absolutely clear that the prudent approach to health care is not about rationing. Instead it aims to deliver health care that fits the needs and circumstances of patients and that actively avoids wasteful care that is not to the patients benefit. Of course it means being attentive to the intervention to outcome calculation or the prudent principle that resources should be expended wisely but it is about an ethical approach to treating patients in which clinical need and clinical prioritisation determine how services are provided. And because of that my third essential principle of prudent health care is that it is infused with a sense of equity. It provides us with a way of going on matching need and spending. So we put our maximum resources where needs are greatest and it allows us to go on preserving and promoting that fundamental Bevan principle that it is your clinical need and nothing else that matters when it comes to deciding your treatment by the National Health Service. Now I want to move on and say something about how such principles might be applied. And I want to say to you that I believe that the principles I've just outlined in which you'll hear more about and in more detail later during the morning apply to the whole of the way in which we think about health services and health care. It begins I believe in recalibrating the relationship between the citizen and the state or between the patient and the service. Here is what the Western Mail said about this in a very useful recent editorial. It said the NHS cannot afford to pay for life saving treatments in the future if giant swaves of us continue to make destructive lifestyle choices. We have to work harder to explain to people the responsibility they have for creating the conditions of health in their own lives. That is very much a prudent medicine principle. The Cfili cohort study that many of you here will be familiar with has published some new data in the last 24 hours. The cohort study for those who don't know it looks at the lives of a large group of men in the Cfili area of Cardiff over a 30 year period. It looks at the choices that people make in their own lives and the impact that that has on their health as they get older. And they look at those basic health behaviours that you'll all be familiar with, not smoking, not drinking to success, eating sensibly, taking exercise, those sorts of basic things. In their conclusions published in the last 24 hours they say that had men in that cohort simply added one extra healthy behaviour to the repertoire which they actually used in their lives then 30 years later that cohort would have 13% less dementia, 12% less diabetes and a 6% reduction in vascular diseases. It's an astonishing real life example of what prudent medicine principles lived in the lives of us not as patients but as citizens make to health and healthcare here in Wales. Now if we move beyond the level of the citizen and move into the realm of public health to population based health, what have we learnt about public health education over the last 30 years? Well on a European scale the lessons are very similar indeed and I think very clear. 30 years of public health education has succeeded hugely in changing people's attitudes. People understand now very well those basic healthcare messages that we have just been rehearsing. It has even succeeded in changing people's intentions. People know what they should do and they have intentions to do things differently. What it has not succeeded in doing is changing actions. It has not succeeded in changing behaviours and that's a major conclusion of the Caerphilly cohort study. So I believe that in a prudent medicine world we have to change the way we think about public health and population based health too. We have to move from education to motivation. We have to move our attention to those things that we can do which change the environment in which people live their lives and then enable them to turn those good intentions into real actions that they can take which make such a difference. If we move beyond public health and think next of primary care then if 2014 is going to be a year in which we talk about prudent medicine then I feel very determined that it has to be a year as well in which we move primary care services to the centre of the stage. Because if we are serious about the principles of prudent medicine then primary care is probably the single most important place where we can start to make this happen. I was very grateful to colleagues in the primary care community for the time they took and the commitment they showed in helping us to reach an agreement on the contract for this next financial year. One of the parts of the new contract that I am most excited about is the new incentives that it puts into the system for practices to work together in clusters and for practices to work beyond the cluster to our partners out there in social care and in the third sector too. If you think in a crude way and I know it's an awful summary of the real position but if you think of the traditional way that people think about health services you can think of them as an escalator in which we are always pushing people up the levels of intervention and which somehow the higher up the level of intervention you go the more prestigious it becomes and the more you feel that you've got something good out of the health service. Now I really want to reverse the escalator. I really want and prudent medicine is really all about this. It is about saying that the more we can do at a citizen level, the more we can do at a population level, the more we can do at a primary care level the better the service we provide to patients and by providing new ways in which primary care is able to work together as that system matures and I feel confident it will mature quickly so our primary care colleagues will be able to act to pull services out from secondary care and down closer to where people live their lives and primary care I think is centre stage for me in the way that prudent medicine principles will work out here in Wales over the coming years. They apply of course equally at hospital level 2 and there are many things that happen already at hospital level that are entirely consistent with the principles I've outlined to you this morning. All hospitals have a document which is called interventions not normally undertaken the IWNU document. I'm glad to be able to say to you this morning that we've already began some work on making sure that we draw these different documents together, that we provide a national list of such interventions. We draw greater attention to them and we make that side of our secondary care a more effective and lively part of the way that the daily business goes along. Now we are all well aware of NICE guidance and recommendations. There's a huge attention in the media on the floor of the assembly as well on whatever next new intervention or treatment NICE is going to approve for the National Health Service. I think it would come as quite a shock to many members of the public to know that NICE has published 867 don't do it clinical guidelines, 867 things that NICE says are no longer clinically worth doing in the health service. If prudent medicine is about not doing things that don't do any good and avoiding things that do harm, then I would like us in secondary care to be paying more attention to those sorts of pieces of advice alongside doing the things that are necessary as well for the future. Let me just summarise three core things, which I think link all these things together. What is the essential case for the prudent medicine approach in practice? Well, first of all, it chimes entirely with the age of austerity because it really means in a serious way, meaning that every pound we spend in the NHS is spent to maximum value. And to maximum effect. Secondly, it puts clinical decision making closer to the heart of everything that we do and puts clinical prioritisation at the forefront of the way that we govern access to services in the NHS. And it provides us with a key new way of conceptualising and then putting into practice our efforts to address health inequalities here in Wales. Now, as well as the things I've already mentioned to you as a key next step, we have already agreed with Public Health Wales that over the next two months we will run a series of workshops mounted by clinicians and in close partnership with the BMA here in Wales in which we will bring people round the table in a desktop exercise to begin with. And we're going to start with four different areas of treatment and conditions. We're going to look at orthopedics, we're going to look at prescribing, we're going to look at ENT services and we're going to look at the services we have for pain management. And we're going to subject each one of those areas to a desktop exercise in which, working with clinicians, we ask ourselves the question, if those services were to be organised on prudent medicine principles, what would they look like for the future? And then, because change is not a choice and because we cannot afford to stand back and simply watch the unfolding film of the NHS in Wales, we will use the learning from those exercises when we are confident that we have got the right set of guidelines to move forward and make a difference to the way that those services are provided on the ground. Bethan, I began by thanking Chris for all the work that he has done over so many years. I want to end just by thanking everybody here in the room today. Because, as we face the challenges that are here in Wales, it is the people who are in this room and all those others that you represent and work with who provide the key to success in the future. And I know that every single day, right across Wales, huge efforts are made to provide the services that people rely on and to find some of the thinking time that we need collectively and between us to go on shaping the service for the future. To have new ideas, to look at new sets of principles that allow us to remain true to the fundamentals of healthcare here in Wales and to shape those for the future. Without you and without everything that you do today will go on doing, none of this will be possible. And yet it is the single most important service that people in Wales have day in, day out and which is so hugely appreciated by them. Diolch, O'r Galon, i chi i gyd am popeth chi'n neud bob dydd ac yn ledled Cymru i helpu bobl sy'n dibynnu, dibynnu bob dydd hefyd ar y gwaith chi a pobl eraill masna an y gwasanaethau iechyd yng Nghymru yn neud. If there is one message that we understand absolutely in Wales, it is that together we are capable of facing the future and solving the problems and the challenges that it faces, I'm immensely grateful to you and all those others for the way you have done it in the past and I know that together we will go on doing it into the future. Diolch yn fawr iawn i chi i gyd.