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I fully support his desire for GPs to become Accountable Officers. For too long, PCTs have been the fall guys of the system. I look forward to the day when a GP Accountable Officer is hauled in to be grilled about overspends and then turfed out with their career in tatters when they couldn't deliver in impossible circumstances.

The reality, however, is that not many GPs are willing to put themselves in this positions. GPs have been moaning from the side lines for years and not taking much responsibility for bringing about change. A leopdard doesn't change it's spots and I cannot think of many NHS reforms that have ever got GPs to accept changes that they don't favour.