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A clown on a unicycle, backpedalling frantically

By trying to please everyone, the Government's 'listening exercise' has turned into a joke

Being firmly in the 'Just let me get on with my job, you interfering bastards' camp, I've never been a great fan of commissioning. But it's with mixed feelings that I note the commissioning juggernaut has transformed into a clown on a unicycle, backpedalling frantically.

This volte face smacks of desperation, with the apparent hope that we'll be so impressed by the latest Big Idea – 'senates' of GPs, nurses and hospital doctors, fer crissakes, to promote the integration of care – that we'll be distracted from the obvious fact that the politicians are just making it up as they go along.

In trying to appease everyone, they'll appeal to nobody. The enthusiasts will lose interest as they face the prospect of commissioning by committee. Whatever happened to that old guff about GPs at the coalface knowing what's best for their patients? With the new plans, we'll have one hand tied behind our back and a plastic shovel.

And as for those, like myself, who weren't interested in the first place, well, we're still not interested. But now we're unnerved, too. Because, even if we didn't like the intended destination, at least we had a sense of direction. Now we're on a road to nowhere.

Dr Tony Copperfield is a GP in Essex

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