The one thing about the commissioning process that I have been quite pleased about has been that it did not involve us hospital consultants. We were merely going to stand on the sidelines and watch as the whole thing went (probably) tits up and our unfortunate GP colleagues were made to carry the can. This may seem a little selfish but it was a nice feeling that we would be pure spectators with no involvement and no responsibility. No blame could fall upon us, all we had to do was carry on doing our normal work under whatever system came our way.
But that bugger Cameron has seen through that, and has now said that he wants us involved as well. I bet he does. The more of us he gets involved the more he can duck the blame in the event of failure. It will be all our fault. Some of our colleagues such as John Black of the Royal College of Surgeons have actually welcomed this idea and are actually enthusiastic about getting sucked into this.
Getting involved with these reforms is going to be like playing pass the parcel with a bomb. I for one don't fancy having the thing go off in my face. I am coming to the conclusion that the only way to win is not to play the game.