Comment : Re-organisation is proceeding despite bizarre mismatch of staff talent

The regions are the 'cockroaches of the NHS', able to withstand any cataclysm, one HSJ source colourfully quipped when the Shifting the Balance re-organisation was announced.

That analysis was prescient: since then, the regional offices - though reduced from eight to four - have been busy ensuring they survive with sizeable teams, despite the advent of strategic health authorities.

Meanwhile, many primary care organisations are still without a finance director, though they are soon to take responsibility for 75 per cent of NHS spending. Some mismatch here, surely?