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Today marks a turning point in the history of NHS commissioning and paves the way to the abolition of some of the most wasteful NHS bodies ever - what on earth have PCTs actually achieved, let's be honest? Have of them are full of people who don't know what they are doing, the other half are full of people meddling and creating paper chases. Your average GP cares deeply about practice list patients and is sick and tired of bureaucracy and small minded, bullying PCT managers. Comments from Terence Lewis at 5.44 today are completely accurate and all I would add is that Mental Health Commissioning as delivered by PCTs has been a complete and utter failure of policy implementation. GPs working in locality commissioning consortia can only improve on dismal leadership shown by PCTs up and down the country.