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A unified strategic approach to use of the estate does make logical sense. However, that ball was dropped with the decision to allow providers to choose to take on bits of the PCT estate, rather than everything going to NHS Property Services. As with many other aspects of the recent reforms, the ideological tensions (centralist vs local, state vs market, however you see it) will be left to play out through disputes between rival power bases, and - I guess - their lawyers. Another win for those guys...