NHS Reorganisation

May I first say that I agree with the Minister that there are too many of these administrative bodies, authorities and trusts and that some reorganisation is called for to achieve some efficiency and reduction in management costs? It would be easier to know where we were going and settle all the boundaries if the Government were consistent about what the reorganisation is actually for. The primary care trusts were set up when the Government abolished GP fundholding. They then suggested that fewer PCTs were required to supervise practice-based budgeting, which is the same thing that they are going back to. They then started to consult on the boundaries on the basis that there should be new commissioning authorities. Halfway through, they changed their mind. They now say that the new PCTs will be commissioning authorities and will directly employ a lot of staff. Consulting in that confusion is quite impossible, which is why we have all the outrage about where the boundaries might go. The Government keep changing their mind on what kind of structure they want for the health service and its vital community-based services. Why does not she stop, start again and try to remain consistent?