This is a real shame because when this idea was introduced I detected a new flush of enthusiasm from colleagues.
Yet again, a good idea has floundered. Each time this happens GPs will become less willing to engage in the process.
PCTs seem to be bound by a mixture of risk adversity and bureaucracy which have completely stifled innovation and delayed developments.
How long can this continue? We don't have world class commissioning; we don't even have economy class commissioning.
It is time GPs were given real budgets, which will create genuine incentives to redesign services. The NHS must be freed from centralised and preferably political control.
Some financial risks need to be taken and a fair but less bureaucratic method of tendering for services needs to be found, otherwise nobody will innovate and we will be stuck where we are.
Dr Paul Charlson, Brough, Cumbria, and chairman Conservative Medical Society.