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Mark Britnell's 'World Class Commissioning' was a load of managerial claptrap. A jingoist idea that failed to realise the extent to which the only people who could ever be 'World Class Commssioners' - GPs - have been alienated, denigrated and subjected to every other kind of negative handling you care to name. Britnell was/is so typical of the NHS 'fast-track' management cadre: bright or intelligent and good at some areas of NHS administration, but lacking a knowledge of what makes people tick, therefore unable to realise the difference between true vision and some steamy-eyed version of Utopia. It remains inexplicable to me how or why such people are allowed so much influence. Britnell should never, ever be allowed to forget or gloss over what was said to an investment conference organised by APAX Partners in New York some time ago: words to the effect that reforms would 'show the NHS no mercy', and now is the time to get in for 'big opportunities' i.e. big profits, for the private sector. Britnell now 'advises' KPMG.