GPs have been saying for years that they are best placed to decide how and where money is spent on health care often citing primary care trusts as dictatorial bureaucrats more interested in targets than the needs of the local community.

And so it came to pass that the health fairy Andrew Lansley granted them their wish on one condition.

The caveat is that GPs take full responsibility for how and where  money is spent and are held accountable for any failings.

GPs are now wising up to the fact that pretty soon there won’t be a primary care trust to conveniently blame and they will be in the firing line as budget holders.

This realisation, along with the huge skills gap they will have to bridge as GP consortia, has come as something of a shock.

In all likelihood, they will have to re-employ a small army of trust staff to keep things working.

And Andrew Lansley is trying sell us his new vision of the NHS by saying he is cutting bureaucracy. Oh really?

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