The quality of care for patients with diabetes is influenced by factors other than medical care, making it difficult to use outcomes as measures of quality. Most measures reported are process measures, which are under the control of doctors and less affected by case mix differences. For example, body mass index recording was less frequent in women, poor people, and ethnic minorities, as well as flu vaccination. These findings suggest poorer quality of care for these groups. The author suggests that financial incentives in the new general practitioner contract may help reduce disparities, but adjusting payments based on deprivation could complicate things and lead to disputes. The search for policies that promote quality, efficiency, and equity in healthcare is ongoing, requiring evaluation of the new contract and willingness to change policies when evidence shows they are not effective. Competing interests are not declared. The article also discusses errors in a previous editorial regarding hepatitis B infections and a support group URL. In Minerva, the affiliations of two authors were switched. The BMJ Learning section discusses multimedia learning, noting that early versions were cluttered and ineffective, but current versions are designed for accessibility and include a new module on psoriasis.The quality of care for patients with diabetes is influenced by factors other than medical care, making it difficult to use outcomes as measures of quality. Most measures reported are process measures, which are under the control of doctors and less affected by case mix differences. For example, body mass index recording was less frequent in women, poor people, and ethnic minorities, as well as flu vaccination. These findings suggest poorer quality of care for these groups. The author suggests that financial incentives in the new general practitioner contract may help reduce disparities, but adjusting payments based on deprivation could complicate things and lead to disputes. The search for policies that promote quality, efficiency, and equity in healthcare is ongoing, requiring evaluation of the new contract and willingness to change policies when evidence shows they are not effective. Competing interests are not declared. The article also discusses errors in a previous editorial regarding hepatitis B infections and a support group URL. In Minerva, the affiliations of two authors were switched. The BMJ Learning section discusses multimedia learning, noting that early versions were cluttered and ineffective, but current versions are designed for accessibility and include a new module on psoriasis.