Are you one of the forces of conservatism? GPs, health authority managers now 'on the brink of extinction' and even the public are guilty. So search your heart and confess: 'An admission that such forces are within us all, and within all parts of the NHS, in its widest sense, is a good beginning, ' writes Dr Tom Coffey.

Dr Coffey is clearly sincere in his devotion to the government's reforms: he chairs a primary care group, helps run the very New Labour New Health Network, and has occasionally been trotted out by the Department of Health to endorse its efforts. But he would do well not to confuse conservatism with scepticism.

One does not need to be a closet member of the Conservative Party to recognise that there are flaws in the reforms. There are flaws in all such programmes - but it is the sceptics, not the zealots, who will spot them in time to avert disaster. One of the least attractive - and most counterproductive - elements of New Labour's control-freakery is its intolerance of dissent. But if doubting the status of every DoH initiative as revealed truth counts as heresy, then long live the heretics.