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The CCGs are not an exercise in localism or Big Society, they are an exercise in state control. Effectively nationalisation will be imposed via the Command and Control culture of the NCB. NCB officers in their various forms will require certain behaviours and decisions: like Pavlov's dogs, compliant CCGs will be periodically rewarded. Its a bit like the old prefecture system in France. This is a good thing, because there is no room in a national health service for local policy differences.

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