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A Q for GPs to ask may be whether DH is proposing reforms designed to shift the job of dealing with public ire at closing hospital services, wards and even whole hospitals (esp DGs) from DH to GPs? The 2006 and 2008 white papers set out a clear strategy and I suspect the coalition just didn't fancy being the party in power when the closures started to bite. If traditionally high public regard for GPs turns against them, they will be decimated, publically and politically. I'm doing some research/survey work on this subject and majority of public say decommissioning will adversely affect their relationship with own GP and of the profession as a whole. GPs should take a long view at the consequences of reform, not just what's in it for them, as they may have a nasty shock waiting for them in 3-5 years time.